促性腺激素释放激素类似物对停药特发性中枢性性早熟女童影响研究

Effect of gonadotropin releasing hormone analogue on girls with idiopathic central precocious puberty

目的探讨促性腺激素释放激素类似物对停药特发性中枢性性早熟女童的影响。方法选取2014年1月至2016年12月四川绵阳四○四医院和江油市第二人民医院诊治的50例女性ICPP患儿作为研究对象。其中由于特殊原因没有对患儿进行药物干预治疗的有25例(对照组),单独用GnRHa进行治疗的有15例(GnRHa组),使用GnRHa联合基因重组人生长激素(recombinant human growth hormone,rhGH)进行治疗的有10例(联合组)。结果三组患儿在实验研究前身高差异均无统计学意义(均P>0.05),三组的成年终身高分别为(151.93±3.35)cm、(151.88±4.05)cm和(149.56±3.62)cm,实验研究后成年终身高分别为(157.06±2.01)cm、(161.35±2.43)cm和(167.75±2.15)cm,GnRHa组和联合组的身高净增长均显著大于对照组,但GnRHa组和联合组间差异无统计学意义(P>0.05)。在实验后三组患儿的预测终身高明显大于实验研究前,且GnRHa组、联合组的身高增长速度更大,实验研究前差异无统计学意义(P>0.05),而实验后差异具有统计学意义(P<0.05);使用GnRHa治疗的GnRHa组、联合组两组的骨龄增长速度明显小于未治疗的对照组,治疗前差异无统计学意义(P>0.05),治疗后差异具有统计学意义(P<0.05);对照组月经初潮年龄小于GnRHa组和联合组,女童月经来潮距离停药的时间长短除与治疗前有无月经初潮有关外,与其他所有因素均不相关。三组在实验研究后的月经初潮年龄分别为(8.54±1.60)岁、(10.53±3.22)岁、(10.86±5.84)岁,结果显示实验研究前后差异均具有统计学意义(均P<0.05)。结论 GnRHa和rhGH对女童特发性中枢性性早熟有一定的治疗效果,在使用促性腺激素释放激素类似物治疗ICPP患儿时如果出现生长速度减慢的情况,可以用rhGH辅助治疗,这对成年终身高等有一定的改善作用。

Objective To investigate the effect of gonadotropin releasing hormone analogue(GnRHa) on girls with idiopathic central precocious puberty(ICPP).Methods 50 female ICPP patients in our hospitals from January 2014 to December 2016 were selected, including 25 cases(control group) did not receive medication intervention due to some reasons, 15 cases(GnRHa group) receiving GnRHa alone for treatment, and 10 cases(combination group) receiving GnRHa combined with rhGH for treatment. Results There was no statistically significant differences in the height of patients among the three groups before treatment(all P>0.05). The final adult height of the three groups was(151.93 ± 3.35) cm,(151.88 ±4.05) cm and(149.56± 3.62) cm, which increased to(157.06 ± 2.01) cm,(161.35±2.43) cm and(167.75 ± 2.15) cm after treatment. The increase in GnRHa group and combination group was significant higher than that in the control group, but no statistically significant difference was found between GnRHa group and combination group(P>0.05). After treatment, the final height of the three groups was significantly higher than that before treatment, and the growth rate in the GnRHa group and the combination group was higher with statistically significant difference after treatment(P < 0.05), though there was no statistically significant difference before treatment(P>0.05). Age of menarche in the control group was less than that in the GnRHa group and the combination group. The age of menarche in the three groups was(8.54 ±1.60) years old,(10.53 ±3.22) years old and(10.86 ±5.84) years old after treatment. The results showed that the differences were statistically significant before and after treatment(all P<0.05).Conclusions GnRHa and rhGH is of certain effect in the treatment of girls with ICPP and rhGH adjuvant therapy can be used to improve final adult height if growth slows down during treatment.