Craniofacial Growth in Short Children Born Small for Gestational Age: Effect of Growth Hormone Treatment
Craniofacial Growth in Short Children Born Small for Gestational Age: Effect of Growth Hormone Treatment
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小于胎龄儿的颅面生长：生长激素治疗的效果
DOI：
10.1177/00220345970760091001
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发表时间：
1997
影响因子：
7.6
通讯作者：
F. Zegher
中科院分区：
文献类型：
--
作者：
R. V. Erum;M. Mulier;Carine Carels;Geert Verbeke;F. Zegher
生长激素(GH)治疗对儿童的影响尚未完全归类。在本研究中，对21名出生时小于胎龄的非生长激素缺乏的青春期前儿童，每年评估一次大剂量生长激素治疗对头面部生长的影响。这些儿童被随机分配为不接受治疗或接受生长激素治疗，每日皮下剂量为0.2或0.3IU/kg，为期2年。该组包括12名女孩和9名男孩，平均年龄5.1岁(范围2-8岁)，骨龄3.4岁，身高标准差-3.6。在研究开始时，所有的儿童都表现出颅面部发育的总体延迟。这组出生时小于胎龄的矮小儿童的SNB角较小，ANB角较大；所有其他角度测量均在正常范围内。GH治疗促进了几个头面部成分的生长，尤其是后面部总高度、颅底长度和下颌总长度。下颌骨长度的增加增加了SNB角，但不影响其他角度的测量。治疗开始时的年龄对后部和总颅底长度的增加、下颌体长的增加以及下颌骨相对于颅底的位置有不同的影响。尽管生长激素治疗2年后导致颅面生长加速，但在大多数生长激素治疗的儿童中，下颌骨相对于颅底的位置和颅面侧面的大小并没有正常化。在大剂量生长激素治疗2年后，没有发现不成比例生长的迹象。总而言之，青春期前矮小的SGA儿童总体上表现出颅面线性生长和下颌骨后移的总体延迟。超过2年的大剂量生长激素治疗导致颅面追赶生长，这在间质软骨受累的区域明显，并导致面部轮廓较少凸起。
The effects of growth hormone (GH) therapy in children have yet to be completely catalogued. In the present study, the effect of high-dose GH treatment on craniofacial growth was evaluated once yearly in 21 pre-pubertal, non-GH-deficient children born small for gestational age. These children were randomly allocated to be either untreated or treated with GH at a daily subcutaneous dose of 0.2 or 0.3 IU/kg for 2 yrs. The group consisted of 12 girls and 9 boys with a mean age of 5.1 yr (range, 2 to 8 yr), bone age of 3.4 yr, and height SDS of -3.6. At the start of the study, all children showed an overall delay of craniofacial growth. This cohort of short children born small for gestational age showed a small SNB angle and a large ANB angle; all other angular measurements were within normal range. GH treatment accelerated growth in several craniofacial components, especially the posterior total facial height, the cranial base length, and the overall mandibular length. The increase of the mandibular length increased the SNB angle; no other angular measurements were affected. Age at start of treatment differently influenced the increase in posterior and total cranial base length, the increase in mandibular corpus length, and the position of the mandible in relation to the cranial base. Although GH treatment for 2 yrs led to a craniofacial growth acceleration, the position of the mandible in relation to the cranial base and the craniofacial size in lateral aspect were not normalized in the majority of the GH-treated children. No signs of disproportional growth were evidenced after 2 yrs of high-dose GH treatment. In conclusion, short pre-pubertal SGA children display an overall delay of linear craniofacial growth and a retrognathic mandible. High-dose GH treatment over 2 yrs leads to craniofacial catch-up growth, which is pronounced in regions where interstitial cartilage is involved and results in a less convex face in profile.
DOI：
10.1210/jcem.80.5.7538146
发表时间：
1995-05
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
L. Giudice;F. de Zegher;S. Gargosky;B. Dsupin;L. de las Fuentes;R. Crystal;R. Hintz;R. Rosenfeld
通讯作者：
L. Giudice;F. de Zegher;S. Gargosky;B. Dsupin;L. de las Fuentes;R. Crystal;R. Hintz;R. Rosenfeld