BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explor...BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.展开更多
Objective:To observe the clinical efficacy of different dosage forms of lepraline acetate(LA)in the treatment of girls with central precocious puberty(CPP).Methods:72 CPP girls treated in the Department of Pediatrics ...Objective:To observe the clinical efficacy of different dosage forms of lepraline acetate(LA)in the treatment of girls with central precocious puberty(CPP).Methods:72 CPP girls treated in the Department of Pediatrics of Huai'an First People's Hospital from February 2021 to August 2022 were included as subjects and divided into two groups:3-month LA group(n=34)and 1-month LA group(n=38).Both group girls were treated for 6 months.Serum hormone levels,body mass index(BMI),bone age/chronological age(BA/CA)and pelvic color ultrasound were detected at 0 and 6 months after treatment,and the changes of various indexes were compared before and after treatment.Results:1)There were no significant differences in baseline data between the two groups before treatment(P>0.05).2)After 6 months of treatment,BA/CA decreased,growth rate slowed down,and predicted adult height increased in both groups(P<0.05),but there were no significant differences between groups(P>0.05).3)After 6 months of treatment,there waere no significant differences in luteinizing hormone(LH)inhibition ratio between the 3 month and 1 month dosage groups(P>0.05).After treatment,the peak value of serum LH and FSH,estradiol level,uterine volume,bilateral ovarian volume,maximum follicle diameter and the number of follicles 4mm were significantly decreased in the two groups,but there were no significant differences between the two groups(P>0.05).4)There were no significant differences in the levels of thyroid hormone,fasting blood glucose and triglyceride between the two groups before and after treatment(P>0.05).Total cholesterol levels were increased after treatment(P<0.05),but there was no significant difference between groups(P>0.05).5)No serious adverse reactions occurred during the treatment of the two dosage forms of LA,but the 3-month dosage form of LA reduced the treatment cost and improved the treatment compliance.Conclusion:The short-term efficacy of 3-month LA in the treatment of CPP in girls is similar to that of 1-month LA.The 3-month dosage form LA is a safe,effective,and economical method for the treatment of CPP in girls.展开更多
In boys, central precocious puberty （CPP） is the appearance of secondary sex characteristics driven by pituitary gonadotropin secretion before the age of 9 years. In the last years, relevant improvements in the trea...In boys, central precocious puberty （CPP） is the appearance of secondary sex characteristics driven by pituitary gonadotropin secretion before the age of 9 years. In the last years, relevant improvements in the treatment of CPP have been achieved. Because CPP is rare in boys, the majority of papers on this issue focus on girls and do not address specific features of male patients regarding end results and safety. In the present paper, recent advances of CPP management with GnRH analogs in men are summarized. End results in untreated and treated patients are also reviewed by an analysis of the recently published literature on treatment of CPP in men. The available data indicate that therapy with GnRH analogs can improve final height into the range of target height without significant adverse short-term and long-term effects, but longer follow-up of larger series of patients is still required to draw definitive conclusions.展开更多
目的 探讨单时相促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)激发试验对不同体重指数(body mass index,BMI)女童中枢性性早熟(central precocious puberty,CPP)的诊断价值。方法 回顾性分析2017年1月—2023年8月在郑州大...目的 探讨单时相促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)激发试验对不同体重指数(body mass index,BMI)女童中枢性性早熟(central precocious puberty,CPP)的诊断价值。方法 回顾性分析2017年1月—2023年8月在郑州大学第三附属医院就诊的7.5岁前出现乳房发育的760例女童数据。根据GnRH激发试验结果和临床表现综合诊断,分为CPP组(n=297)和非CPP组(n=463)。再根据体重指数(body mass index,BMI)分为正常体重组(n=540)、超重组(n=116)及肥胖组(n=104)。采用受试者操作特征曲线分析单时相GnRH激发试验对不同BMI女童CPP的诊断价值。结果 GnRH激发后30 min黄体生成素(luteinizing hormone,LH)/卵泡刺激素诊断CPP的曲线下面积为0.985,高于0、60、90 min LH/卵泡刺激素的曲线下面积(P<0.05)。30 min与60 minLH诊断价值相当(P>0.05)。30 min LH与BMI及BMI-Z值呈负相关(P<0.05)。30 min LH在正常体重、超重、肥胖女童中诊断CPP的曲线下面积分别为0.952、0.965、0.954 (P<0.05)。结论 30 min GnRH激发试验对不同BMI女童CPP均有较好的诊断价值,有望替代传统的GnRH激发试验,但应注意BMI对LH水平的影响。展开更多
目的探究食欲素A(Orexin-A)对女童中枢性性早熟的影响。方法选取2021年1月1日至2022年12月31日以来某妇幼保健院收治的特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童30例为ICPP组,单纯性乳房发育女童30例为单纯...目的探究食欲素A(Orexin-A)对女童中枢性性早熟的影响。方法选取2021年1月1日至2022年12月31日以来某妇幼保健院收治的特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童30例为ICPP组,单纯性乳房发育女童30例为单纯性乳房早发育(premature thelarche,PT)组,健康女童30例为对照组。收集患儿资料。对ICPP组患儿进行治疗并随访,检测患儿治疗前后血清Orexin-A水平。评价Orexin-A在ICCP诊断中的价值。结果ICPP组一般资料中身高、体重、骨龄、骨龄与年龄比值和阴毛发育评分,均高于PT组和对照组(P<0.05);3组患儿的血清学指标中,ICPP组的Orexin-A低于其他两组,E 2、LH、FSH、PRL显著高于PT组和对照组(P<0.05)。盆腔B超资料中,ICPP组的子宫容积、内膜厚度、卵巢容积、最大卵泡直径显著高于其他两组(P<0.05)。多因素分析显示,BMI、Orexin-A、子宫容积是女童ICPP的独立影响因素(P<0.05)。Orexin-A诊断ICPP的AUC为0.913,灵敏度为0.800,特异度为0.933。结论ICPP女童的身体和第二性征提前发育,E 2、LH、FSH和PRL激素水平上升,血清Orexin-A水平下降,卵巢和子宫发育提前,同时Orexin-A在诊断ICPP方面有良好的参考价值,具有较高的灵敏度和特异度,可以为性早熟筛查提供帮助。展开更多
目的探讨促性腺激素释放激素类似物(GnRHa)联合重组人生长激素(rhGH),单用GnRHa治疗对有月经初潮的特发性中枢性性早熟(ICPP)女童身高的影响。方法回顾性分析2014年1月至2020年12月于徐州医科大学附属徐州儿童医院儿童生长发育门诊就诊7...目的探讨促性腺激素释放激素类似物(GnRHa)联合重组人生长激素(rhGH),单用GnRHa治疗对有月经初潮的特发性中枢性性早熟(ICPP)女童身高的影响。方法回顾性分析2014年1月至2020年12月于徐州医科大学附属徐州儿童医院儿童生长发育门诊就诊76例有月经初潮的ICPP女童为研究对象,根据治疗方案分为治疗对照组(n=22),单用GnRHa治疗组(n=22)和GnRHa联合rhGH治疗组(n=32),随访观察至接近成年终身高(near final adult height,NFAH),比较三组病儿NFAH、身高净生长(ΔHt)、遗传增高(NFAH-遗传身高)。结果对照组、GnRHa组、联合用药组三组就诊基线身高、体质量、身体质量指数(BMI)、骨龄、遗传靶身高差异无统计学意义(P>0.05),随访NFAH分别(158.27±3.63)cm、(159.61±3.91)cm、(162.61±3.34)cm,ΔHt分别(12.66±3.54)cm、(13.49±3.06)cm、(16.79±3.17)cm,遗传增高分别(−2.32±3.82)cm、(0.16±3.46)cm、(3.52±4.62)cm,三组间均差异有统计学意义(P<0.05),其中联合用药组与GnRHa组、对照组比较均差异有统计学意义(P<0.05);GnRHa组和对照组在遗传增高方面差异有统计学意义(P<0.05),在NFAH、ΔHt方面比较均差异无统计学意义(P>0.05)。结论对已有月经初潮的ICPP女孩,GnRHa联合rhGH治疗,可改善NFAH,但需权衡治疗成本及身高获益,临床应谨慎推荐,单用GnRHa治疗不改善NFAH,可改善遗传增高。展开更多
文摘BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.
基金Jiangsu Province Maternal and Child Health Care Project (No.FYX202213)。
文摘Objective:To observe the clinical efficacy of different dosage forms of lepraline acetate(LA)in the treatment of girls with central precocious puberty(CPP).Methods:72 CPP girls treated in the Department of Pediatrics of Huai'an First People's Hospital from February 2021 to August 2022 were included as subjects and divided into two groups:3-month LA group(n=34)and 1-month LA group(n=38).Both group girls were treated for 6 months.Serum hormone levels,body mass index(BMI),bone age/chronological age(BA/CA)and pelvic color ultrasound were detected at 0 and 6 months after treatment,and the changes of various indexes were compared before and after treatment.Results:1)There were no significant differences in baseline data between the two groups before treatment(P>0.05).2)After 6 months of treatment,BA/CA decreased,growth rate slowed down,and predicted adult height increased in both groups(P<0.05),but there were no significant differences between groups(P>0.05).3)After 6 months of treatment,there waere no significant differences in luteinizing hormone(LH)inhibition ratio between the 3 month and 1 month dosage groups(P>0.05).After treatment,the peak value of serum LH and FSH,estradiol level,uterine volume,bilateral ovarian volume,maximum follicle diameter and the number of follicles 4mm were significantly decreased in the two groups,but there were no significant differences between the two groups(P>0.05).4)There were no significant differences in the levels of thyroid hormone,fasting blood glucose and triglyceride between the two groups before and after treatment(P>0.05).Total cholesterol levels were increased after treatment(P<0.05),but there was no significant difference between groups(P>0.05).5)No serious adverse reactions occurred during the treatment of the two dosage forms of LA,but the 3-month dosage form of LA reduced the treatment cost and improved the treatment compliance.Conclusion:The short-term efficacy of 3-month LA in the treatment of CPP in girls is similar to that of 1-month LA.The 3-month dosage form LA is a safe,effective,and economical method for the treatment of CPP in girls.
文摘In boys, central precocious puberty （CPP） is the appearance of secondary sex characteristics driven by pituitary gonadotropin secretion before the age of 9 years. In the last years, relevant improvements in the treatment of CPP have been achieved. Because CPP is rare in boys, the majority of papers on this issue focus on girls and do not address specific features of male patients regarding end results and safety. In the present paper, recent advances of CPP management with GnRH analogs in men are summarized. End results in untreated and treated patients are also reviewed by an analysis of the recently published literature on treatment of CPP in men. The available data indicate that therapy with GnRH analogs can improve final height into the range of target height without significant adverse short-term and long-term effects, but longer follow-up of larger series of patients is still required to draw definitive conclusions.
文摘目的 探讨单时相促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)激发试验对不同体重指数(body mass index,BMI)女童中枢性性早熟(central precocious puberty,CPP)的诊断价值。方法 回顾性分析2017年1月—2023年8月在郑州大学第三附属医院就诊的7.5岁前出现乳房发育的760例女童数据。根据GnRH激发试验结果和临床表现综合诊断,分为CPP组(n=297)和非CPP组(n=463)。再根据体重指数(body mass index,BMI)分为正常体重组(n=540)、超重组(n=116)及肥胖组(n=104)。采用受试者操作特征曲线分析单时相GnRH激发试验对不同BMI女童CPP的诊断价值。结果 GnRH激发后30 min黄体生成素(luteinizing hormone,LH)/卵泡刺激素诊断CPP的曲线下面积为0.985,高于0、60、90 min LH/卵泡刺激素的曲线下面积(P<0.05)。30 min与60 minLH诊断价值相当(P>0.05)。30 min LH与BMI及BMI-Z值呈负相关(P<0.05)。30 min LH在正常体重、超重、肥胖女童中诊断CPP的曲线下面积分别为0.952、0.965、0.954 (P<0.05)。结论 30 min GnRH激发试验对不同BMI女童CPP均有较好的诊断价值,有望替代传统的GnRH激发试验,但应注意BMI对LH水平的影响。
文摘目的探讨促性腺激素释放激素类似物(GnRHa)联合重组人生长激素(rhGH),单用GnRHa治疗对有月经初潮的特发性中枢性性早熟(ICPP)女童身高的影响。方法回顾性分析2014年1月至2020年12月于徐州医科大学附属徐州儿童医院儿童生长发育门诊就诊76例有月经初潮的ICPP女童为研究对象,根据治疗方案分为治疗对照组(n=22),单用GnRHa治疗组(n=22)和GnRHa联合rhGH治疗组(n=32),随访观察至接近成年终身高(near final adult height,NFAH),比较三组病儿NFAH、身高净生长(ΔHt)、遗传增高(NFAH-遗传身高)。结果对照组、GnRHa组、联合用药组三组就诊基线身高、体质量、身体质量指数(BMI)、骨龄、遗传靶身高差异无统计学意义(P>0.05),随访NFAH分别(158.27±3.63)cm、(159.61±3.91)cm、(162.61±3.34)cm,ΔHt分别(12.66±3.54)cm、(13.49±3.06)cm、(16.79±3.17)cm,遗传增高分别(−2.32±3.82)cm、(0.16±3.46)cm、(3.52±4.62)cm,三组间均差异有统计学意义(P<0.05),其中联合用药组与GnRHa组、对照组比较均差异有统计学意义(P<0.05);GnRHa组和对照组在遗传增高方面差异有统计学意义(P<0.05),在NFAH、ΔHt方面比较均差异无统计学意义(P>0.05)。结论对已有月经初潮的ICPP女孩,GnRHa联合rhGH治疗,可改善NFAH,但需权衡治疗成本及身高获益,临床应谨慎推荐,单用GnRHa治疗不改善NFAH,可改善遗传增高。
