目的：探讨重组人生长激素（r-hGH）对特发性矮小（ISS）儿童的糖、脂代谢及甲状腺功能的影响。方法选取2009年1月至2013年1月应用r-hGH治疗并定期随访的ISS儿童47例，年龄为10±3岁，治疗期限为3~24个月，随访间隔为每3个月1次，检测治疗后0~1年及治疗后1~2年时的空腹血糖、胰岛素、血脂、甲状腺功能等指标的变化。结果 r-hGH治疗后，患儿空腹血糖、胰岛素水平、胰岛素敏感指数、空腹血糖/胰岛素比值（FGIR）与治疗前比较差异无统计学意义，但FGIR有下降趋势；FGIR<7（提示胰岛素抵抗）的患儿治疗前为13%（6/47），治疗后1~2年为18%（4/22）。治疗后动脉粥样硬化指数较前下降，而总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平及BMI与治疗前比较差异无统计学意义。治疗前后甲状腺功能无明显变化。结论 r-hGH治疗ISS儿童是安全可靠的，可改善脂代谢，对甲状腺功能、空腹血糖、胰岛素水平无明显影响，但有胰岛素敏感性降低的可能。?????????????????[中国当代儿科杂志，2014，16（12）：1236-1240]
ObjectiveTo study the effects of recombinant human growth hormone (r-hGH) replacement therapy on glucose and lipid metabolism and thyroid function in children with idiopathic short stature (ISS).MethodsForty-seven ISS children with a mean age of 10±3 years treated between January 2009 and January 2013 were enrolled. All children underwent r-hGH replacement therapy for 3-24 months and were followed up once every 3 months. Fasting blood glucose (FBG), insulin (INS), blood lipids and thyroid function were measured before treatment and after 0-1 and 1-2 years of treatment.ResultsAfter treatment with r-hGH, there were no signiifcant changes in FBG, INS, insulin sensitivity index (ISI), and FBG/ INS ratio (FGIR), but the FGIR showed a declining trend. The percentage of patients with FGIR<7 (a marker of insulin resistance) was 13% before treatment compared to 18% 1-2 years after treatment. The atherosclerosis index decreased after r-hGH treatment, but there were no signiifcant changes in total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and BMI. Furthermore, no signiifcant change in thyroid function was observed after r-hGH therapy.Conclusionsr-hGH therapy can improve lipid metabolism, without signiifcant impacts on thyroid function, FBG and INS. It seems to be a safe and reliable therapy for children with ISS. However, this therapy possibly reduces insulin sensitivity.