GnRHa对特发性中枢性性早熟女孩生长的影响

Effects of Gonadotropin-Releasing Hormone Analogue (GnRHa) on Growth of Girls with Idiopathic Precocious Puberty

[目的]探讨促性腺激素释放激素类似物(GnRHa)致特发性中枢性性早熟(ICPP)女孩生长减速的机制。[方法]对接受GnRHa治疗的13例ICPP女孩,观察治疗前6个月、治疗后第一、第二个6个月的生长速度(GV0、GV6和GV12),分别于治疗开始时、6个月末和12个月末,行空腹血清胰岛素样生长因子1(IGF-1)和胰岛素样生长因子结合蛋白3(IGFBP-3)浓度测定,计算IGF-1和IGFBP-3的比值。[结果]GV6[(6.86±1.73)cm/年]与GV0[(7.25±0.94)cm/年]无显著差异,GV12[(4.96±1.47)cm/年]显著慢于GV0(P=0.005)。GnRHa治疗开始时、6个月末和12个月末的IGF-1[1(0.50±0.16)、(0.49±0.18)和(0.52.4±0.14)mg/L]、IGFBP-3[(3.50±0.70)、(3.56±0.85)和(3.75±0.70)mg/L]和IGF-1/IGFBP-3[(0.15±0.039)、(0.14±0.048)和(0.14±0.026)]均无显著差异。[结论]ICPP女孩接受GnRHa治疗6个月后生长开始明显减速,并与血清IGF-1、IGFBP-3浓度和IGF-1/IGF-BP-3值的改变无关。

[Objective] To probe into the mechanism of growth reduction in girls with idiopathic precocious puberty(ICPP) treated with gonadotropin-releasing hormone analogue(GnRHa). [Methods] Subjects were 13 girls with ICPP treated with GnRHa. Growth velocity was observed in the six months before GnRHa administration(GV0), the first and second six months after GnRHa treatment (GV6 and GV12). Serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) concentrations were measured and molar ratios of IGF-1 and IGFBP-3 (IGF-1/IGFBP-3) were calculated at the beginning, the end of 6th and 12th months of GnRHa therapy. [Results] GV6[ (6. 86±1. 73)cm/y] was similar to GVo[(7. 25±0. 94) cm/y], while GV12[(4. 96±1. 47) cm/y] was much less than GV0 (P = 0. 005). There were no significant changes in serum IGF-1 [ (0. 50±0. 16), (0. 49±0. 18) and (0.52±0. 14) mg/L, respectively] or IGFBP-3 [(3. 50±0. 70), (3. 56±0. 85) and (3.75±0.70) mg/L respectively] or IGF-1/IGFBP-3 [(0. 15±0. 039), (0. 14 ±0. 048) and (0. 14 ±0. 026) respectively] at the beginning, the end of 6th month or 12th month of GnRHa therapy. [Conclusion] Growth reduction in girls with ICPP becomes obvious after 6 months GnRHa treatment, which doesn't attribute to the change of serum IGF-1, IGFBP-3 concentration or IGF-1/IGFBP-3.