摘要
目的:观察促性腺激素释放激素类似物曲普瑞林治疗女童特发性中枢性性早熟(ICPP)的临床疗效.方法:选取某院2008-2012年确诊的68例ICPP女童,予曲普瑞林治疗1~2年,观察治疗前后乳房、子宫容积、卵巢容积、促黄体生成素峰值(P-LH)、促卵泡刺激素峰值(P-FSH)、血清雌二醇(E2)与随疗程进行的体质量指数(BMI)、骨龄(BA)、骨龄与生活年龄比值(BA/CA)、预测成年身高(PAH)、身高年龄对骨龄的追赶(HtSDSBA)、生长速率(GV)的动态变化及药物不良反应.同时选取52例未经治疗的ICPP患儿作为对照组,随访1~2年,测量各阶段乳房、子宫容积、卵巢容积、P-LH、P-FSH、E2以及BMI、BA等指标并进行比较.结果:治疗后患儿乳房、子宫、卵巢容积均有缩小,P-LH、P-FSH、E2均显著降低,骨龄成熟延迟,BA/CA值下降,身高年龄对骨龄的追赶、PAH治疗后较治疗前有改善,差异具有统计学意义(P< 0.05);而未经治疗的对照组ICPP患儿乳房、子宫、卵巢容积有不同程度的增大,骨龄进展,BA/CA升高.结论:曲普瑞林治疗ICPP能有效抑制下丘脑-垂体-性腺轴及性征发育,延缓BA成熟,改善成年终身高.
OBJECTIVE:To evaluate the efficacy of the GnRHa triporelin for girls with idiopathic central precocious puberty (ICPP).METHODS:Totally 68 girls confirmed as having ICPP were treated with triporelin for 1-2 years,with the volume of uterus and ovary,LH (luteinizing hormone) peak,follicle stimulating hormone (FSH) peak,serum level of E2,body mass index (BMI),bone age,bone age/age (BA/CA),predicted adult height (PAH),height standard deviation score for bone age (HtSDS-BA),dynamic change in growth velocity (GV) the drug side effects followed.Meanwhile,another 52 cases of untreated ICPP children were assigned to control group and followed up for 1 to 2 years with regard to the changes in the volume of uterus and ovary,LH peak,FSH peak,BMI and BA.The indexes were compared between the two groups.RESULTS:After treated with triporelin,the volume of breast,uterus and ovary dwindled significantly; the peak levels of serum LH and FSH and serum E2 level were also significantly reduced,with delayed maturation of BA,decrease in BA/CA ratio,improvement in HtSDSBA and the predicted adult height (PHA),and the differences were statistically significant (P<0.05); however,in the control group,the volume of breast,uterus and ovaries increased in varying degrees,the BA progressed and the BA/CA ratio increased.CONCLUSIONS:Treatment with triporelin can effectively suppress the hypothalamic-pituitary-gonadal and sex characteristic development,delay the BA maturation and finally improve the adult height in girls with ICPP.
出处
《中国医院用药评价与分析》
2014年第4期309-312,共4页
Evaluation and Analysis of Drug-use in Hospitals of China