不同剂量醋酸亮丙瑞林微球治疗女童中枢性性早熟临床评价

Efficacy Evaluation of Different Dose of Leuprorelin Acetate Microspheres in the Treatment of Girls with Central Precocious Puberty

目的探讨不同剂量醋酸亮丙瑞林微球治疗女童中枢性性早熟的临床疗效。方法选取医院2017年3月至2020年3月收治的中枢性性早熟女性患儿267例,随机分为高剂量组、低剂量组和对照组,各89例。3组患儿均给予醋酸甲地孕酮片口服,高、低剂量组分别加用醋酸亮丙瑞林微球90μg/kg和30μg/kg皮下注射,均连续治疗3个月。结果高、低剂量组总有效率分别为94.38%和91.01%,明显高于对照组的82.02%(P <0.05),高、低剂量组间差异无统计学意义(P> 0.05);治疗后,高、低剂量组患儿的雌二醇、卵泡刺激素、黄体生成素水平均明显低于对照组,卵巢体积、子宫体积、骨龄均明显小于对照组(P <0.05),高、低剂量组间差异无统计学意义(P> 0.05);高剂量组不良反应发生率为14.61%,明显高于低剂量组的5.62%和对照组的3.37%(P <0.05)。结论 90μg/kg和30μg/kg醋酸亮丙瑞林微球治疗女童中枢性性早熟均有一定疗效,能改善患儿的子宫体积、卵巢体积、骨龄等临床指标,降低性激素水平,且30μg/kg剂量给药时不良反应发生率更低。

Objective To investigate the clinical efficacy of different dose of leuprorelin acetate microcapsule in the treatment of girls with central precocious puberty.Methods A total of 267 girls with central precocious puberty admitted to our hospital from March2017 to March 2020 were selected and randomly divided into the high-dose group,the low-dose group and the control group,89 cases in each group.The girls in the three groups took Megestrol Acetate Tablets orally,on this basis,the girls in the high-dose group and low-dose group were given 90,30μg/kg of Leuprorelin Acetate Microspheres for Injection respectively by subcutaneous injection.All of them were continuously treated for three months.Results The total effective rates of the high-dose group and the low-dose group were 94.38%and 91.01%,which were significantly higher than 82.02%of the control group(P<0.05).After treatment,the levels of estradiol(E2),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the high-dose group and the low-dose group were significantly lower than those in the control group,and the ovarian volume,uterine volume and bone age in the high-dose group and the low-dose group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the high-dose group was 14.61%,which was significantly higher than 5.62%in the low-dose group and 3.37%in the control group(P<0.05).Conclusion Leuprorelin acetate microspheres(90,30μg/kg)in the treatment of girls with central precocious puberty have a certain curative effect,which can improve the uterine volume,ovarian volume,bone age and other clinical indicators,reduce the levels of sex hormone.However,30μg/kg of leuprorelin acetate microspheres have a lower incidence of adverse reactions.