不同剂量醋酸曲普瑞林对特发性中枢性性早熟患儿性激素及骨代谢的影响

Effects of triptorelin acetate at different doses on sex hormone and bone metabolism in children with idiopathic central precocious puberty

目的分析不同剂量醋酸曲普瑞林对特发性中枢性性早熟患儿性激素及骨代谢的影响。方法收集2020年5月至2022年1月儿科收治的特发性中枢性性早熟患儿72例,根据电脑随机数字表法分组,每组36例。对照组予以80μg/kg醋酸曲普瑞林治疗,观察组予以60μg/kg醋酸曲普瑞林治疗,12个月后比较2组患儿的临床疗效、发育指标、性激素、骨代谢指标及安全性。结果观察组患儿的总有效率为97.22%,对照组为94.44%,差异无统计学意义(P>0.05);2组患儿的预测成年身高、身高标准差分值(HtSDSBA)与骨龄均高于治疗前,而生长速率低于治疗前(P<0.05),但2组间比较,差异无统计学意义(P>0.05);2组患儿的雌二醇(E2)、促黄体生成素(LH)与促卵泡生成素(FSH)均低于治疗前(P<0.05),但2组间比较,差异无统计学意义(P>0.05);2组患儿的骨钙素N端中分子片段(N-MID)与Ⅰ型原胶原氨基端肽(PINP)水平均低于治疗前(P<0.05),但2组间比较,差异无统计学意义(P>0.05);观察组中不良反应发生率为5.56%低于对照组的25.00%(P<0.05)。结论不同剂量醋酸曲普瑞林在特发性中枢性性早熟患儿中的应用均可取得显著效果,可有效改善其发育指标、性激素及骨代谢指标,但低剂量醋酸曲普瑞林在安全性方面更具优势。

Objective To analyze the effects of triptorelin acetate at different doses on sex hormone and bone metabolism in children with idiopathic central precocious puberty.Methods A total of 72 children with idiopathic central precocious puberty admitted to the Department of Pediatrics of our hospital from May 2020 to January 2022 were recruited.They were randomly divided into control group(n=36)and observation group(n=36)according to computer random number table.They were treated with triptorelin acetate at 80μg/kg and 60μg/kg,respectively.The clinical efficacy,developmental indexes,sex hormones,bone metabolism indexes and safety of the two groups were compared after 12 months.Results After treatment,there was no significant difference in the total effective rate between the observation group and control group(97.22%vs 94.44%,P>0.05).The predicted adult height,height standard deviation score(SDS)for bone age(HtSDSBA)and bone age of children in the both groups were significantly higher than those before treatment,while the growth rate was significantly lower(P<0.05).There were no significant differences in the predicted adult height,HtSDSBA,bone age and growth rate after treatment between groups(P>0.05).After treatment,estradiol(E2),luteinizing hormone(LH)and follicle stimulating hormone(FSH)levels in the both groups were significantly lower than those before treatment(P<0.05),which were comparable between groups(P>0.05).After treatment,the levels of N-midfragment osteocalcin(N-Mid OC)and procollagen type I N-propeptide(PINP)in both groups were significantly lower than those before treatment(P<0.05),which were comparable between groups(P>0.05).The incidence of adverse events was significantly lower in the observation group than that in the control group(5.56%vs 25.00%,P<0.05).Conclusion Triptorelin acetate at different doses are effective in children with idiopathic central precocious puberty,which can effectively improve their developmental indexes,sex hormones and bone metabolism indexes.The low-dose triptorelin acetate has more advantages in the safety.