重组人生长激素联合亮丙瑞林对女童中枢性性早熟的干预效果评价

Efficacy evaluation of recombinant human growth hormones combined with leuprorelin for interventing central precoclous puberty female-children(5.2-10.0yr.)

目的评价重组人生长激素联合亮丙瑞林对5.2~10.0岁女童中枢性性早熟(CPP)干预效果。方法选取69例CPP女童,选择首次治疗≤7岁患儿为A组,首次治疗>7岁者为B组。两组患儿均接受亮丙瑞林治疗,治疗半年后若患儿预测成年身高无法达到靶身高则联合应用重组人生长激素。两组患儿的疗程均为1年以上,治疗停止后半年随访一次,观察初潮出现时间、第二性征、月经情况、性激素水平及性腺发育,随访至患儿达到实际终身高。结果治疗前A、B两组患儿在骨龄、治疗起始年龄、骨龄与生活年龄比值及治疗前预测最终身高均有显著差异(P<0.05)。治疗停止时骨龄、年龄、预测成年身高及实际剩余生长能力差异显著(P<0.05)。停止亮丙瑞林治疗后A组患儿与B组相比性激素指标显著降低(P<0.05)。结论 CPP患儿采用亮丙瑞林干预治疗可改善成年身高,应注意及早治疗,合理调整剂量及联合用药,以改善患儿实际终身高。

Objective To evaluate the efficacy of recombinant human growth hormones combined with leuprorelin for interventing remaining growth ability in（CPP） central precocious puberty female-child. Methods The 69 girls with CPP were divided into two groups：the younger group ≤7yr. and the older group 〉7yr.,their body height were followed up every half year by the end of treatment,and gonadogenesis condition,the levels of sex hormone,secondary sex characters,the time of menarche appear and its regularity were observed. The follow up lasted until the girls body height no longer increase. The difference between their predicted adult height and final body height were analyzed. Results There were a significant difference in the ratio between age and bone age,along age,predicted body height and bone age before treatment （P〈0.05）. There were a significant difference in predicted body height,along age,bone age,practical body height,predicted remaining growth ability and practical remaining growth ability by the end of treatment（P〈0.05）. There were a significant difference on the levels of sex hormone bewteen the two groups by the end of treatment （P〈0.05）. Conclusion For the girls with CPP the treatment with leuprorelin to improve adult body height must be immediately,rationally utilizing the recombinant human growth hormone,and adjusting drug dosage in time to assure the final body height.