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,洪泽区人民医院;2.南京医科大学附属淮安第一医院;3.徐州医科大学淮安临床学院

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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.Huai’an Clinical College of Xuzhou Medical University,Hongze People ’s Hospital;2.the Affiliated Huai ’an No.1 People ’s Hospital of Nanjing Medical University

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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(PEG-recombinant human growth hormone,PEG-rhGH)治疗前后淋巴细胞亚群、免疫球蛋白、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月至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0、3月时两组患儿身高、骨龄、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无显著差异,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组治疗后CD3+、CD4+ 细胞比例和CD4+/CD8+以及 IgA、IgM、IgG水平较前升高,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+ 细胞比例无显著差异;治疗后PEG-rhGH组Th1/Th2细胞因子IL-2、IL-6、IL-10及TNF-α水平较前降低,显著低于对照组,两组IL-4和IFN-γ水平仍无显著差异。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水平。

    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 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 Huaian First People's Hospital and Hongze District People's Hospital. According to the preferences of the participants, they were allocated into PEG-rhGH group (n=30) and control group (n=25). The control group received exercise, diet, and sleep interventions, while the PEG-rhGH group was adtered PEG-rhGH treatment based on these interventions. Measurements of height, bone age, BMI, insulin-minislike growth factor-1 (IGF-1), lymphocyte subsets, helper T cell cytokines, and immunoglobulin levels were conducted at baseline and 3 months post-treatment. Comparative analysis was performed to assess changes in various parameters before and after the intervention. Results: There were no significant differences between the two groups prior to treatment. After 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 was no significant disparity in the proportion of CD19+ and CD3-CD16+CD56+ cells between the two groups. After treatment, IL-2, IL-6, IL-10 and TNF-α cytokine levels significantly decreased in the PEG-rhGH group while IL-4 and IFN-γ levels remained unchanged compared to those in control group. Conclusion: When PEG-rhGH enhances stature among children with GHD ,it ?also influences the level of cellular and humoral immune.

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  • 收稿日期:2024-09-01
  • 最后修改日期:2024-11-02
  • 录用日期:2024-11-26
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