促性腺激素释放激素拟似剂对儿童特发性性早熟各生长指标的影响

Effects of gonadotropin releasing hormone on the growth indexes of children with idiopathic precocious puberty

目的探究促性腺激素释放激素拟似剂(GnRH-a)对儿童特发性性早熟(ICPP)各生长指标的影响。方法选取2015年6月至2017年6月延安大学附属医院诊治的25例特发性性早熟儿童作为研究对象。所有患儿均给予GnRH-a治疗,50~80ug/kg,每周1次,连续治疗1年,对患儿治疗前后激素水平变化情况、身高、体重、骨龄等生长指标变化情况以及性发育积分变化进行综合评价。结果对所有患儿给予为期1年的随访,结果显示患儿治疗后6个月、治疗后1年的促黄体生成素(LH)、雌二醇(E2)、促卵泡激素(FSH)等指标均得到显著改善(P<0.05),与治疗前比较差异存在统计学意义;经过为期1年的治疗,患儿身高、体重显著增长,与治疗前比较有统计学意义(P<0.05),患儿骨龄增长速度有所减缓,预测身高治疗后6个月、12个月分别增长至(150.89±2.24)cm、(155.24±1.98)cm,差异无统计学意义(P>0.05);治疗后6个月、12个月女童患儿子宫、卵巢、乳房以及阴毛等性发育积分均显著降低,与治疗前比较差异具有统计学意义(P<0.05)。结论促性腺激素释放激素拟似剂治疗儿童特发性性早熟,能够延缓骨龄发育,改善身高,促进激素水平恢复正常,值得推广应用。

Objective To explore the effect of gonadotropin releasing hormone(GnRH-a)on the growth indexes of children with idiopathic precocious puberty(ICPP).Methods 25 children with idiopathic precocious puberty in our hospital from June 2015 to June 2017 were selected and givenGnRH-a treatment,50~80 ug/kg,once a week,for a year.Changes in the hormone level,skeletal age,height,weight,growth index andsex development integral between before and after treatment were comprehensively evaluated.Results Theluteinizing hormone(LH),estradiol(E2)and follicle stimulating hormone(FSH)and other indicators were improved significantly at 6 months and a year after treatment,with statistically significantdifferences(P<0.05).After a year of treatment,the height and weight of the children increased significantly,with statistically significant differences compared with that before treatment(P<0.05),while the growth of skeletal age slowed which was predicted to be(150.89±150.89)cm and(155.24±1.98)cm at 6 months and 12 months after treatment respectively,without statistically significant difference compared with that before treatment(P>0.05).The integral scores of uterus,ovary,breast and pubic hair at 6 months and 12 months after treatment were significantly decreased compared with those before treatment,with statistically significant difference(P<0.05).Conclusions Gnrh-a is effective for the treatment of children with idiopathic precocious puberty,which can delay the development of skeletal age,improve height,and promote the recovery of hormone level,which is worth popularizing in clinical.