曲普瑞林对特发性中枢性性早熟女童的临床疗效和对骨龄的影响

Clinical efficacy of triptorelin for girls with idiopathic central precocious puberty and its effect on bone age

目的研究曲普瑞林对特发性中枢性性早熟女童的临床疗效。方法回顾性分析2018年1月至2020年12月在镇江市第一人民医院确诊为特发性中枢性性早熟女童68例的临床资料,年龄(8.21±1.55)岁,病程(13.42±2.97)个月。68例患儿均使用注射用曲普瑞林治疗,分别将治疗12个月前后相关资料进行对比分析。计量资料治疗前后比较用配对t检验。结果治疗12个月后,特发性中枢性性早熟女童的体质量、身高、成年后最终身高预测(PAH)有所增加,生长速度趋于正常,骨龄进展延缓,骨龄/年龄有所降低(均P<0.05);治疗12个月后,特发性中枢性性早熟女童的卵泡刺激素(FSH)、黄体生成素(LH)的基础值与雌二醇(E_(2))水平和子宫、卵巢容积都有所降低(均P<0.05);在治疗前有4个以上且直径大于等于4 mm卵泡的女童有31例,治疗12个月后减少至12例,第二性征情况减缓、不良反应极少。结论应用曲普瑞林治疗特发性中枢性性早熟可以有降低女童体内性激素,延迟患儿第二性征的展现,达到与正常年龄相符的生长发育,减缓骨骼的过早闭合,使患儿正常发育,不良反应情况少,值得应用与推广。

Objective To study the clinical effect of triptorelin for girls with idiopathic central precocious puberty.Methods The clinical data of 68 girls diagnosed with idiopathic central precocious puberty in Zhenjiang First People's Hospital from January 2018 to December 2020 were retrospectively analyzed,whose age was(8.21±1.55)years old and the course of disease was(13.42±2.97)months.All the 68 girls were treated with triptorelin for injection,and the related data before and after 12 months of treatment were compared and analyzed.Paired t test was used to compare the measurement data before and after treatment.Results After 12 months of treatment,the body weight,height,and predicted adult height(PAH)in girls with idiopathic central precocious puberty increased,the growth rate tended to be normal,the bone age progression was delayed,and the bone age/age decreased(all P<0.05).After 12 months of treatment,the baseline values of follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E_(2))and uterine and ovarian volumes in girls with idiopathic central precocious puberty decreased(all P<0.05).Before treatment,31 girls had 4 or more follicles with diameter greater than or equal to 4 mm,which decreased to 12 cases after 12 months of treatment,the secondary sexual characteristics were alleviated,and the adverse reactions were rare.Conclusions The use of triptorelin for girls with idiopathic central precocious puberty can reduce the levels of sex hormones,delay the display of secondary sexual characteristics in girls,and achieve growth and development consistent with normal age,slow down the premature closure of bones,and make girls develop normally,with few adverse reactions,which is worthy of application and promotion.