The Growth of Nephrotic Children Treated with Steroids

使用腎上腺皮質類固醇治療的腎變性症小孩之發育曲線

陳烱暉(Chiung-Hui Chen)

《Acta Paediatrica Sinica》 11卷3期 (1970/09) Pp. 89-99

摘要

於八個腎變性症小孩，使用腎上腺皮質類固醇治療並且追蹤六至十一年。觀察及測量其身高及體重結果發現八病例中七病例在治療開始後有一段時期呈現發育促進現象。另一病例無呈現發育促進現象。繼續五年以上的腎上腺皮質類固醇長期治療可能影響最後的發育成就。

並列摘要

Long term therapy with ACTH and adrenocorticosteroids may inhibit the linear growth in animal, in premature and children as well as in the patients with asthma. The degree of suppression of linear growth due to steroids is dependent on the compounds used. When children with other conditions are treated for prolonged period with enough cortisone and prednisolone, there is also evidence of linear growth retardation which may be reverted by discontinuing therapy or by reducing dosage below a critical growth suppression level. Bauer and Fleisher have shown that linear growth of nephrotic children is retarded during the active phase of the disorder and becomes accelerated during, spontaneous or induced remission in a follow-up study of 50 months. The degree of suppression of linear growth is not serious enough to preclude the use of steroids in the treatment of the nephritic syndrome because the growth inhibitions is reversible and the untreated disease might interfere with growth to an equal or greater extent. Moreover, it is generally accepted that children with the nephrotic syndrome need long term therapy with steroids.
Long term therapy with ACTH and adrenocorticosteroids may inhibit the linear growth in animal(superscript 1-3), in premature^4 and children^5 as well as in the patients with asthma(superscript 6,7). The degree of suppression of linear growth due to steroids is dependent on the compounds used. When children with other conditions are treated for prolonged period with enough cortisone and prednisolone, there is also evidence of linear growth retardation which may be reverted by discontinuing therapy or by reducing dosage below a critical growth suppression level. Bauer^9 and Fleisher^(10) have shown that linear growth of nephrotic children is retarded during the active phase of the disorder and becomes accelerated during, spontaneous or induced remission in a follow-up study of 50 months. The degree of suppression of linear growth is not serious enough to preclude the use of steroids in the treatment of the nephritic syndrome because the growth inhibitions is reversible and the untreated disease might interfere with growth to an equal or greater extent. Moreover, it is generally accepted that children with the nephrotic syndrome need long term therapy with steroids^(11).
No papers on ultimate growth achieve-merit of nephrotic children treated with long term of adrenocorticosteroids have been published. The present study is to show the effect of long term therapy of steroids on growth rate and ultimate growth achievement of eight nephrotic children followed up for 6 to 11 years.