促性腺激素释放激素类似物在特发性中枢性性早熟女童中的应用

Application of gonadotropin-releasing hormone analogues in girls with idiopathic central precocious puberty

目的探讨促性腺激素释放激素类似物(GnRHa)在特发性中枢性性早熟(ICPP)女童中的应用。方法回顾性分析阳江市妇幼保健院2015年3月~2020年3月采用GnRHa治疗的350例ICPP女童的临床资料,比较治疗前、治疗3、6个月患儿的体重指数(BMI)、骨龄、血清脂联素(ADPN)及甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]的变化情况。结果治疗3个月后、治疗6个月后BMI均低于治疗前,差异有统计学意义(P<0.05);治疗6个月后与治疗3个月后BMI比较,差异无统计学意义(P>0.05)。治疗前、治疗3、6个月后骨龄比较,差异均无统计学意义(P>0.05)。治疗3、6个月后ADPN均高于治疗前,治疗6个月后高于治疗3个月后,差异均有统计学意义(P<0.05)。治疗3、6个月后FT3均高于治疗前,治疗6个月后低于治疗3个月后,差异均有统计学意义(P<0.05)。治疗3个月后FT4高于治疗前,治疗6个月后低于治疗3个月后,差异均有统计学意义(P<0.05);治疗6个月后FT4与治疗前比较,差异无统计学意义(P>0.05)。治疗3个月后TSH高于治疗前,治疗6个月后低于治疗3个月后与治疗前,差异均有统计学意义(P<0.05)。结论GnRHa治疗ICPP女童,ADPN水平明显升高,BMI、甲状腺功能逐渐恢复正常。

Objective To explore the application of gonadotropin-releasing hormone analogue(GnRHa)in girls with idiopathic central precocious puberty(ICPP).Methods Retrospective analysis was performed on the clinical data of 350 cases of ICPP girls treated with GnRHa in Yangjiang Maternal and Child Health Hospital from March 2015 to March 2020,and the changes of body mass index(BMI),bone age,adiponectin(ADPN)and thyroid function(free tri-iodothyronine[FT3],free thyroxine[FT4],thyroid stimulating hormone[TSH])were compared among before and after 3 months of treatment,and 6 months after treatment.Results After 3 months of treatment and 6 months of treatment,the BMI indexes were lower than those before treatment,the differences were statistically significant(P<0.05);the difference of BMI between after 3 months of treatment and after 6 months of treatment was not statistically significant(P>0.05).There was no significant difference in bone age at different times among before treatment,after 3 months of treatment and after 6 months of treatment(P>0.05).After 3 months of treatment and after 6 months of treatment,the levels of ADPN were higher than those before treatment,the level of ADPN after 6 months of treatment was higher than that after 3 months of treatment,the differences were statistically significant(P<0.05).After 3 months of treatment and 6 months of treatment,the levels of FT3 were higher than those before treatment,the level of FT3 after 6 months of treatment was lower than that after 3 months of treatment,the differences were statistically significant(P<0.05).After 3 months of treatment,the level of FT4 was higher than that before treatment,the level of FT4 after 6 months of treatment was lower than that after 3 months of treatment,the differences were statistically significant(P<0.05);there was no statistically significant difference in FT4 levels after 6 months of treatment and before treatment(P>0.05).The TSH level after 3 months of treatment was higher than that before treatment,and the TSH level after 6 months of treatment was lower than those after 3 months of treatment and before treatment,the differences were statistically significant(P<0.05).Conclusion During the treating of GnRHa for ICPP in girls,ADPN is significantly increasing and BMI and thyroid function gradually returning to normal.