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中华肾病研究电子杂志 ›› 2018, Vol. 07 ›› Issue (06) : 277 -279. doi: 10.3877/cma.j.issn.2095-3216.2018.06.008

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综述

肾病综合征儿童矮身材的机制与治疗
卢枚1, 高春林1, 杨晓1, 夏正坤1,()   
  1. 1. 210002 南京,南方医科大学临床医学院(南京军区南京总医院)儿科
  • 收稿日期:2018-03-05 出版日期:2018-12-28
  • 通信作者: 夏正坤

Mechanism and treatment of short stature in children with nephrotic syndrome

Mei Lu1, Chunlin Gao1, Xiao Yang1, Zhengkun Xia1,()   

  1. 1. Department of Pediatrics, Nanjing General Hospital of Nanjing Military Region, Clinical Medical College of Southern Medical University, Nanjing 210002, China
  • Received:2018-03-05 Published:2018-12-28
  • Corresponding author: Zhengkun Xia
  • About author:
    Corresponding author: Xia Zhengkun, Email:
引用本文:

卢枚, 高春林, 杨晓, 夏正坤. 肾病综合征儿童矮身材的机制与治疗[J]. 中华肾病研究电子杂志, 2018, 07(06): 277-279.

Mei Lu, Chunlin Gao, Xiao Yang, Zhengkun Xia. Mechanism and treatment of short stature in children with nephrotic syndrome[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2018, 07(06): 277-279.

原发性肾病综合征(PNS)是儿童常见肾脏病。糖皮质激素及其他免疫抑制剂的广泛应用使肾病综合征的治愈率及生存率得到了显著的提高。但肾病综合征自身复杂的病理生理机制及糖皮质激素等免疫抑制剂的长期使用导致了肾病综合征患儿生长发育迟缓问题越显突出,而儿童时期生长发育对成年后的身高具有重要影响。对于PNS儿童矮身材的防治目前尚无系统的成熟的方案,应用重组人生长激素治疗矮身材儿童是目前的主要手段,但其安全性及有效性仍需要进一步的研究给予证实。

Primary nephrotic syndrome (PNS) is a common kidney disease in children. The widespread use of glucocorticoids and other immunosuppressive agents has significantly improved the cure rate and survival rate of nephrotic syndrome patients. However, the complex pathophysiological mechanism of nephrotic syndrome and the long-term use of immunosuppressive agents such as glucocorticoids have led to the more prominent growth retardation in children with nephrotic syndrome, although the growth and development in childhood has an important influence on their heights at adult. There is no systematic and mature scheme for the prevention and treatment of short stature in children with PNS. The use of recombinant human growth hormone to treat short stature of children with PNS is currently the main means, but its safety and efficacy still need further researches for confirmation.

[12]
Ocaranza P, Lammoglia JJ, Iniguez G, et al. Effects of thyroid hormone on the GH signal transduction pathway [J]. Growth Horm IGF Res, 2014, 24(1): 42-46.
[13]
Rogol AD. Sex steroids, growth hormone, leptin and the pubertal growth spurt [J]. Endocr Dev, 2010, 17: 77-85.
[14]
de Lemos SG, Tirapegui J. Growth hormone secretion and nutrition [J]. Arq Gastroenterol, 1994, 31(4): 159-172.
[15]
易著文,刘建华. 原发性肾病综合征患儿生长激素-胰岛素样生长因子轴的变化与生长障碍[J].中华儿科杂志,1999,37(4):235.
[16]
Allen DB. Inhaled corticosteroids and growth: still an issue after all these years [J]. J Pediatr, 2015, 166(2): 463-469.
[17]
Altowati MA, Russell RK, Ahmed SF. Endocrine therapy for growth retardation in paediatric inflammatory bowel disease [J]. Paediatr Drugs, 2014, 16(1): 29-42.
[18]
Wolthers OD, Ramshanker N, Heuck C, et al. The timing of administration of exogenous glucocorticoid affects 24hour growth hormone secretion in children [J]. Growth Horm IGF Res, 2017, 35(1): 40-44.
[19]
Tsampalieros A, Gupta P, Denburg MR, et al. Glucocorticoid effects on changes in bone mineral density and cortical structure in childhood nephrotic syndrome [J]. J Bone Miner Res, 2013, 28(3): 480-488.
[20]
Ribeiro D, Zawadynski S, Pittet LF, et al. Effect of glucocorticoids on growth and bone mineral density in children with nephrotic syndrome [J]. Eur J Pediatr, 2015, 174(7): 911-917.
[21]
Hartmann K, Koenen M, Schauer S, et al. Molecular actions of glucocorticoids in cartilage and bone during health, disease, and steroid therapy [J]. Physiol Rev, 2016, 96(2): 409-447.
[22]
Simmonds J, Grundy N, Trompeter R, et al. Long-term steroid treatment and growth: a study in steroid-dependent nephrotic syndrome [J]. Arch Dis Child, 2010, 95(2): 146-149.
[23]
Skrzypczyk P, Panczyk-Tomaszewska M, Roszkowska-Blaim M, et al. Long-term outcomes in idiopathic nephrotic syndrome: from childhood to adulthood [J]. Clin Nephrol, 2014, 81(3): 166-173.
[24]
Marimuthu V, Krishnamurthy S, Rajappa M. Non-autoimmune subclinical and overt hypothyroidism in idiopathic steroid-resistant nephrotic syndrome in children [J]. Indian Pediatr, 2017, 54(11): 925-929.
[25]
Mehlman CT, Ain MC. Evaluation of the child with short stature [J]. Orthop Clin North Am, 2015, 46(4): 523-531.
[26]
Allen DB, Backeljauw P, Bidlingmaier M, et al. GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults [J]. Eur J Endocrinol, 2016, 174(2): P1-P9.
[1]
中华医学会儿科学分会肾脏学组.儿童激素敏感、复发/依赖肾病综合征诊治循证指南(2016)[J].中华儿科杂志,2017,(10):729-734.
[2]
中华医学会儿科学分会肾脏学组.激素耐药型肾病综合征诊治循证指南(2016)[J].中华儿科杂志,2017,(11):805-809.
[3]
Hjorten R, Anwar Z, Reidy KJ. Long-term outcomes of childhood onset nephrotic syndrome [J]. Front Pediatr, 2016, 4: 53.
[4]
Donatti TL, Koch VH. Final height of adults with childhood-onset steroid-responsive idiopathic nephrotic syndrome [J]. Pediatr Nephrol, 2009, 24(12): 2401-2408.
[5]
闫洁.儿童矮身材诊治进展[J].中华实用儿科临床杂志,2016,(23):1778-1782.
[6]
Saenger PH, Mejia-Corletto J. Long-acting growth hormone: an update [J]. Endocr Dev, 2016, 30: 79-97.
[7]
Kanaley JA. Growth hormone, arginine and exercise [J]. Curr Opin Clin Nutr Metab Care, 2008, 11(1): 50-54.
[8]
Tritos NA, Biller BM. Growth hormone and bone [J]. Curr Opin Endocrinol Diabetes Obes, 2009, 16(6): 415-422.
[9]
Rosen CJ. Growth hormone and aging [J]. Endocrine, 2000, 12(2): 197-201.
[10]
Chinoy A, Murray PG. Diagnosis of growth hormone deficiency in the paediatric and transitional age [J]. Best Pract Res Clin Endocrinol Metab, 2016, 30(6): 737-747.
[11]
Pascual A, Aranda A. Thyroid hormone receptors, cell growth and differentiation [J]. Biochim Biophys Acta, 2013, 1830(7): 3908-3916.
[27]
Loke KY, Yap HK, Zhou X, et al. Efficacy and safety of one year of growth hormone therapy in steroid-dependent nephrotic syndrome [J]. J Pediatr, 1997, 130(5): 793-799.
[28]
Sato M, Ito S, Ogura M, et al. Impact of rituximab on height and weight in children with refractory steroid-dependent nephrotic syndrome [J]. Pediatr Nephrol, 2014, 29(8): 1373-1379.
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