关于改善中枢性性早熟患儿身高获益的思考

Considerations on the improvement of height benefit in children with central precocious puberty

随着遗传和环境等多种因素的改变,儿童性早熟的发病率逐渐增加,以改善身高为目的的性早熟治疗是临床关注的重点问题之一。目前,促性腺激素释放激素类似物(gonadotropin-releasing hormone analogs,GnRHa)仍是首选治疗药物,但其对身高的改善作用受多种因素影响,可能导致身高获益低于预期。联合重组人生长激素(recombinant human growth hormone,rhGH)治疗是提高GnRHa疗效的可选治疗策略,然而联用时机等尚无明确推荐。基于性早熟治疗现状,重新审视单用GnRHa及联合rhGH治疗对身高的改善作用至关重要。该文探索了联合治疗适应证等策略,以期指导临床用药,帮助性早熟患儿实现更理想的身高获益。

With the changes in various factors such as genetics and the environment,the incidence of childhood precocious puberty has been gradually increasing.Improving height is one of the key issues in the clinical management of precocious puberty.Currently,gonadotropin-releasing hormone analogs(GnRHa)remain the preferred treatment for precocious puberty,but their effect on height improvement is influenced by multiple factors,which may result in lowerthan-expected height benefits.Combining recombinant human growth hormone(rhGH)therapy with GnRHa treatment is an alternative strategy to enhance the efficacy of GnRHa,but there is still no clear recommendation regarding the timing of their combination.Considering the current status of precocious puberty treatment,it is crucial to reevaluate the effects of GnRHa monotherapy and combination therapy with rhGH on height improvement.This article discusses strategies such as combination therapy indications to guide clinical medication and help children with precocious puberty achieve optimal height benefits.