GnRHa治疗中枢性性早熟女童对终身高的影响

Impact of gonadotropin-releasing hormone analogs treatment on final height in girls with central precocious puberty

目的观察促性腺激素释放激素类似物(GnRHa)对治疗中枢性性早熟(central precocious puberty,CPP)女童终身高的作用及相关因素。方法对26例CPP女童应用GnRHa治疗前后预测身高、骨龄的标准差分值[HtSDS(BA)]、终身高、体重指数(BMI)、初潮情况等进行评价,分析它们与终身高的相关性。结果治疗前预测身高为151.5±5.7cm;停药时预测身高为158.4±5.2cm;终身高为158.0±4.0cm,高于靶身高155.3±4.4cm(P<0.01)。终身高与初始身高、预测身高、HtSDS(BA)正相关。治疗前BMI为17.1±2.1、治疗后BMI为19.9±3.2,两者呈正相关。停药后平均13.2±6.1个月后初潮,平均初潮年龄为12.2±0.7岁。结论GnRHa治疗CPP可有效地改善终身高,终身高与治疗前身高及预测身高等密切相关,停药后患儿青春发育与正常儿童相似。

Objective To study the effects of treatment with gonadotropin-releasing hormone analogs （GnRHa） on final height, weight and pubertal development in girls with central precocious puberty. Methods Twenty-six girls with central precocious puberty were treated with GnRHa for an average of 19.2 ± 8.4 months. Pretreatment and posttreatment predicted adult heights （PAH） were evaluated based on the Bayley-Pineau table. The patients＇ heights and weights were measured monthly. Bone age （BA） was evaluated using Greulich-Plyle. Height standard deviation score for BA [ HtSDS （BA） ] was measured. After discontinuation of treatment, the patients were followed-up for the observation of height, weight, BA and menstruation. Results Final height averaged 158.0 ± 4.0 cm in the 26 girls, which was greater than their target height （ 155.3 ±4.4 cm; P 〈 0.01 ） and consistent with their posttreatment PAH （ 158.4 ± 5.2 cm）. The final height was positively corrrelated with initial height, PAH and HtSDS （BA）. There was a positive correlation in the body mass index before and after treatment （r = 0.724,P 〈 0.01 ）. Menarche occurred 13.2 ± 6.1 months after discontinuation of treatment, with a mean menarche age of 12.2 ± 0.7 years. Conclusions GnRHa may increase final height in gifts with central precocious puberty. Their final heights may be correlated with their initial heights and PAH. The pubertal development after GnRHa treatment in girls with central precocious puberty may be matched with normal children.