缓释型促性腺激素释放激素与生长激素治疗儿童中枢性性早熟的疗效观察

Effect of short term of combined treatment with Gonadotropin-releasing hormone analogues and Growth hormone in central precocious puberty

目的 用生长激素与促性腺激素释放激素类似物 (Gonadotropin -releasinghormoneanalogues,GHA)联合治疗中枢性性早熟女性患儿对其最终成人身高的影响。方法 :生长激素 (GH)与促性腺激素释放激素类似物 (GHA)联合治疗 4例中枢性性早熟女性患儿半年 ,对比治疗前后患儿的第二性征 ,骨龄发育 ,性激素及最终成人身高的变化。结果 :第二性征的发育停止 ,骨龄发育被控制 ,实际生活年龄与骨年龄的比值提高 (平均 0 79→ 0 84 ) ;血LH对促性腺激素释放激素的反应及血浆雌激素水平平均已降至青春期前 ,分别为 (平均 2 5 79± 1 0 60mlu/ml→ 1 .1 3± 0 .2 1mlu/ml)及 (平均 64 87± 2 7 5 1 pg/ml→ 3 .0 3± 1 .87pg/ml) ;预测最终成人身高增加 (平均 1 4 9 60± 4 3 1cm→ 1 5 6.75± 3 .84cm)差异具有显著性 (P <0 0 5 )。结论 :生长激素与GHA联合治疗中枢性性早熟患儿 ,不仅能抑制第二性征发育 ,而且能有效改善最终成人身高 。

Objective: To recognize the changes in find adult height of girls with centrel precocious puberty(CPP)treated of combination by gonadotropin-releasing hormone analogues(GnRHa) and growth hormore(GH).Methods: The girls with CPP were treated by GnRHa and GH in half past year.The change of secondary sexual characteristics,advance of bone age,sex steroids and predicted fing adult height were abserved during treatment.Results: The results showed that drug could inhibit secondary sexual characteristics,advance of bone age was inhibited.The ratio of the chronologic age/bore age was rised from(mean 0.70)to(mean 0.84).The LH response to intravenous GnRH was reduced to prepubertal level from(mean 25.79 mlu/ml)to (mean 1.13mlu/ml).Plasma oestreadiol decreased to prepubertal level from (mean 64.87 pg/ml)to (mean 3.03pg/ml).Predicted final adult height increased significantly from pretreatment(mean 149.60cm)to(mean 156cm)P<0.05.Condusion: The CPP was treated of combination with GnRHa and GH.That could not only inhibit secondary sexucl characteristics,but also increase find adult height effectively without any side effects.