生长激素缺乏症儿童应用聚乙二醇重组人生长激素治疗前后免疫状态的变化
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1.徐州医科大学淮安临床学院儿科,江苏 淮安 223300 ;2.洪泽区人民医院儿科,江苏 淮安 223100 ;3.南京医科大学附属淮安第一人民医院儿科,江苏 淮安 223300

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R723.2

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江苏省妇幼保健协会科研项目(FYX202213)


Alterations in immune status among pediatric patients with growth hormone deficiency pre-and post-treatment with PEGylated recombinant human growth hormone
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1.Department of Pediatrics,Huai’an Clinical College of Xuzhou Medical University,Huai’an 223300 ;2.Department of Pediatrics,Hongze People’s Hospital,Huai’an 223100 ;3.Department of Pediatrics,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University,Huai’an 223300 ,China

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    摘要:

    目的:观察生长激素缺乏症(growth hormone deficiency,GHD)儿童在应用聚乙二醇重组人生长激素(polyethylene glycol-conjugated-recombinant human growth hormone,PEG-rhGH)治疗前后淋巴细胞亚群、免疫球蛋白、辅助T细胞(Th1/Th2)细胞因子水平等免疫指标的变化,探讨PEG-rhGH对GHD儿童免疫功能的影响。方法:选取2022年5月—2023年6月就诊于淮安市第一人民医院及洪泽区人民医院儿科的55例GHD患儿为研究对象,依据患者意愿将其分为对照组(n=25)和PEG-rhGH组 (n=30),对照组予以运动、饮食及睡眠指导,PEG-rhG组在此基础上给予PEG-rhGH治疗,检测治疗前和治疗3个月时两组患儿身高、骨龄、体重指数(body mass index,BMI)、血胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、淋巴细胞亚群、Th1/Th2 细胞因子、免疫球蛋白(immunoglobulin,Ig)水平等,比较治疗前后各项指标的变化。结果:治疗前两组患儿各项指标基线水平差异无统计学意义,治疗3个月PEG-rhGH组身高标准差、生长速率及血IGF-1水平较前升高,显著高于对照组患儿;PEG-rhGH 组CD3+ 、CD4+ 细胞比例和CD4+ /CD8+ 以及IgA、IgM、IgG水平较治疗前升高,显著高于对照组,而CD8+ 细胞比例较前降低,显著低于对照组,两组CD19+ 及CD3- CD16+ CD56+ 细胞比例差异无统计学意义;PEG-rhGH组Th1/Th2细胞因子白介素(interleukin, IL)-2、IL-6及肿瘤坏死因子-α水平较治疗前降低,显著低于对照组,两组IL-4和干扰素γ水平差异无统计学意义。结论:PEG- rhGH治疗GHD患儿改善其身高时,还影响其细胞免疫和体液免疫。

    Abstract:

    Objective:The study aimed to investigate the impact of polyethylene glycol-conjugated recombinant human growth hormone(PEG-rhGH)treatment on immune function in children with growth hormone deficiency(GHD),by analyzing changes in lymphocyte subsets,immunoglobulin levels,and T helper cell(Th1/Th2)cytokines before and after treatment. Methods:Fifty-five children diagnosed with GHD were enrolled as study participants from May 2022 to June 2023 at the Department of Pediatrics of Huai’ an First People’s Hospital and Hongze District People’s Hospital. According to the preferences of the participants,they were allocated into a control group(n=25)and a PEG-rhGH group(n=30). The control group received guidance on exercise,diet,and sleep,while the PEG-rhGH group received PEG-rhGH treatment in addition to these interventions. Measurements of height,bone age,BMI,insulin-like growth factor -1(IGF -1),lymphocyte subsets,Th1/Th2 cytokines,and immunoglobulin(Ig)levels were conducted at baseline and 3 months post-treatment. The changes in various parameters before and after the intervention were compared. Results:Before treatment,there were no significant differences in the baseline levels of the various indicators between the two groups. After 3 months of treatment,the standard deviation of height,growth rate,and serum IGF-1 level in the PEG-rhGH group significantly increased compared to pre-treatment levels and were notably higher than those in the control group. After treatment,the PEG-rhGH group demonstrated a significantly higher proportion of CD3+ ,CD4+ and CD4+ /CD8+ as well as elevated levels of IgA,IgM,and IgG compared to the control group,while the proportion of CD8+ cells was notably lower in the PEG-rhGH group than in the control group,There were no significant differences in the proportion of CD19 + and CD3- CD16 + CD56 + cells between the two groups. Additionally,the levels of Th1/Th2 cytokines,interleukin(IL)-2,IL-6,and tumor necrosis factor-α(TNF-α)in the PEG-rhGH group were significantly lower after treatment compared to before,and were significantly lower than those in the control group. There were still no significant differences in the levels of IL-4 and interferon-γ(IFN-γ)between the two groups. Conclusion:PEG-rhGH treatment not only improves the height of GHD children but also affects their cellular immunity and humoral immunity.

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谭娟,汤勇泉,王汇通,陈冠宇,王映丹,周文娣.生长激素缺乏症儿童应用聚乙二醇重组人生长激素治疗前后免疫状态的变化[J].南京医科大学学报(自然科学版),2024,(12):1696-1701

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  • 收稿日期:2024-09-03
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  • 在线发布日期: 2024-12-16
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