10. Một số yếu tố ảnh hưởng đến tốc độ tăng chiều cao khi điều trị bằng hormone tăng trưởng ở trẻ nhỏ so với tuổi thai

Abstract

Growth hormone (GH) therapy for children born small for gestational age (SGA) who have failed to catch up with growth has been shown to be effective. However, growth responsive both short-term and long-term from GH treatment in SGA patients is heterogeneous because of many factors involved. We studied 43 children with growth retardation due to SGA on GH treatment during at least 12 months. The children were evaluated clinically including their age at the beginning of receiving treatment, the degree of height delay and bone age with growth rate. The effectiveness in height improvement was evaluated depending on the gestation age, the age of started treatment, the bone age, the IGF1 level, and the height at the start of treatment. Of 43 children, 14 were born premature and 29 full-term; the age group are: 2 - 4 years old: 39.5%, 5 - 8 years old: 37.2 % and 9 - 16 years old: 23.3%. The effectiveness in height Z-score after 1 year of treatment of the 2 - 4 years old group, 5 - 8 years old group, and 9 - 16 years old groups were 1.03SD, 0.64SD, 0.5SD, respectively; the premature and full-term children were 0.92SD and 0.64SD, respectively. There was a linear relationship between age and bone age as well as height at the start of treatment with change in height after 1 year. The smaller the age and bone age at the start of treatment, the faster the rate of height change after 1 year, the lower the height at the start of treatment, the more pronounced the height change after treatment. There was no linear relationship between IGF1 or gestational age at diagnosis and height improvement. We concluded that early initiation of GH treatment improved growth outcomes.