促性腺激素释放激素类似物联合生长激素治疗中枢性性早熟女童疗效观察

Effects of GnRHa joint rh GH for girls with central precocious puberty

目的:评估促性腺激素释放激素类似物联合生长激素治疗低预测成人身高的中枢性性早熟女童的治疗疗效。方法:21例确诊为中枢性性早熟同时伴有低预测成人身高的女童被纳入研究,给予促性腺激素释放激素类似物(曲普瑞林)治疗,至少18个月,当身高增长减慢、预测成年终身高不再改善时加用生长激素(基因重组人生长激素)治疗,至少12个月。观察治疗后青春期发育抑制情况,预测成年终身高及对骨龄的身高标准差的动态变化。结果:治疗后青春期发育明显抑制。在18个月的治疗后,预测成年身高(PAH)从(154.5±2.5)cm增加至(162.7±3.1)cm,显著增加。对骨龄的身高标准差(Ht SDSBA)从治疗开始时的(1.12±0.83)下降至(0.79±0.76)(治疗后6个月)、(0.56±0.67)(治疗后12个月)、(0.45±0.51)(治疗后18个月)。结论:促性腺激素释放激素类似物治疗有效地抑制了CPP性腺轴启动,及时添加生长激素能够有效的保证生长速度从而达到更好的成年终身高。

Objectives：To evaluate the efficacy of gonadotropin-releasing hormone（GnRHa） joint recombinant human Growth Hormone（rh GH） in treating girls with central precocious puberty（CPP） and poor height prediction.Methods：21 girls with CPP and poor height prediction were treated with GnRHa over 18 months and rh GH for at least 12 months.Results：The clinical pubertal development was arrested and levels of sex steroids were significantly reduced.The predicted adult height（PAH） was increased significantly from（154.5 ± 2.5） cm to（162.7± 3.1） cm over the 18 months of treatment.The height SDS adjusted for bone age decreased significantly from（1.12 ± 0.83） at the onset of treatment,（0.79 ± 0.76） at 6 month of treatment,（0.56 ± 0.67） at 12 month of treatment and to（0.45 ± 0.51） at 18 month of treatment respectively.Conclusion：GnRHa efficiently inhibits the gonadotropic axis in girls with CPP but timely addition of rh GH is important for maintaining growth velocity and can attain a better final adult height.