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
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
目的观察促性腺激素释放激素类似物(gonadotropin-releasing hormone analogs,GnRHa)对不同体重指数(body mass index,BMI)特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童的治疗效果。方法采取回顾性分析的方法,...目的观察促性腺激素释放激素类似物(gonadotropin-releasing hormone analogs,GnRHa)对不同体重指数(body mass index,BMI)特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童的治疗效果。方法采取回顾性分析的方法,选取2013年1月至2017年8月收治的90例接受GnRHa治疗的ICPP女童作为研究对象。根据就诊时BMI分为正常体重组38例、超重组27例和肥胖组25例。对比分析各组女童治疗前和治疗后1年时的身高增长速率、体重增长速率、BMI、预测成年身高和高度标准偏离评分(hight standard deviation score,HtSDS)。结果与治疗前比较,所有女童身高增长速率、体重增长速率均降低,预测成年身高、HtSDS均有所提高,差异有统计学意义(P<0.01);正常体重组BMI有所增加、而超重组和肥胖组BMI有所降低,差异有统计学意义(P<0.01)。治疗后各组女童身高增长速率、预测成年身高、HtSDS比较差异无统计学意义(P>0.05)。正常体重组体重增长速率高于其余2组,BMI高于超重组,但低于肥胖组,差异有统计学意义(P<0.05)。结论GnRHa对不同BMI的ICPP女童的治疗效果相近,但对于正常体重的ICPP女童,可能存在加快体重增长和增加BMI的影响。展开更多
目的探讨促性腺激素释放激素类似物对停药特发性中枢性性早熟女童的影响。方法选取2014年1月至2016年12月四川绵阳四○四医院和江油市第二人民医院诊治的50例女性ICPP患儿作为研究对象。其中由于特殊原因没有对患儿进行药物干预治疗的...目的探讨促性腺激素释放激素类似物对停药特发性中枢性性早熟女童的影响。方法选取2014年1月至2016年12月四川绵阳四○四医院和江油市第二人民医院诊治的50例女性ICPP患儿作为研究对象。其中由于特殊原因没有对患儿进行药物干预治疗的有25例(对照组),单独用GnRHa进行治疗的有15例(GnRHa组),使用GnRHa联合基因重组人生长激素(recombinant human growth hormone,rhGH)进行治疗的有10例(联合组)。结果三组患儿在实验研究前身高差异均无统计学意义(均P>0.05),三组的成年终身高分别为(151.93±3.35)cm、(151.88±4.05)cm和(149.56±3.62)cm,实验研究后成年终身高分别为(157.06±2.01)cm、(161.35±2.43)cm和(167.75±2.15)cm,GnRHa组和联合组的身高净增长均显著大于对照组,但GnRHa组和联合组间差异无统计学意义(P>0.05)。在实验后三组患儿的预测终身高明显大于实验研究前,且GnRHa组、联合组的身高增长速度更大,实验研究前差异无统计学意义(P>0.05),而实验后差异具有统计学意义(P<0.05);使用GnRHa治疗的GnRHa组、联合组两组的骨龄增长速度明显小于未治疗的对照组,治疗前差异无统计学意义(P>0.05),治疗后差异具有统计学意义(P<0.05);对照组月经初潮年龄小于GnRHa组和联合组,女童月经来潮距离停药的时间长短除与治疗前有无月经初潮有关外,与其他所有因素均不相关。三组在实验研究后的月经初潮年龄分别为(8.54±1.60)岁、(10.53±3.22)岁、(10.86±5.84)岁,结果显示实验研究前后差异均具有统计学意义(均P<0.05)。结论 GnRHa和rhGH对女童特发性中枢性性早熟有一定的治疗效果,在使用促性腺激素释放激素类似物治疗ICPP患儿时如果出现生长速度减慢的情况,可以用rhGH辅助治疗,这对成年终身高等有一定的改善作用。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.
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.
文摘目的观察促性腺激素释放激素类似物(gonadotropin-releasing hormone analogs,GnRHa)对不同体重指数(body mass index,BMI)特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童的治疗效果。方法采取回顾性分析的方法,选取2013年1月至2017年8月收治的90例接受GnRHa治疗的ICPP女童作为研究对象。根据就诊时BMI分为正常体重组38例、超重组27例和肥胖组25例。对比分析各组女童治疗前和治疗后1年时的身高增长速率、体重增长速率、BMI、预测成年身高和高度标准偏离评分(hight standard deviation score,HtSDS)。结果与治疗前比较,所有女童身高增长速率、体重增长速率均降低,预测成年身高、HtSDS均有所提高,差异有统计学意义(P<0.01);正常体重组BMI有所增加、而超重组和肥胖组BMI有所降低,差异有统计学意义(P<0.01)。治疗后各组女童身高增长速率、预测成年身高、HtSDS比较差异无统计学意义(P>0.05)。正常体重组体重增长速率高于其余2组,BMI高于超重组,但低于肥胖组,差异有统计学意义(P<0.05)。结论GnRHa对不同BMI的ICPP女童的治疗效果相近,但对于正常体重的ICPP女童,可能存在加快体重增长和增加BMI的影响。
文摘目的探讨促性腺激素释放激素类似物对停药特发性中枢性性早熟女童的影响。方法选取2014年1月至2016年12月四川绵阳四○四医院和江油市第二人民医院诊治的50例女性ICPP患儿作为研究对象。其中由于特殊原因没有对患儿进行药物干预治疗的有25例(对照组),单独用GnRHa进行治疗的有15例(GnRHa组),使用GnRHa联合基因重组人生长激素(recombinant human growth hormone,rhGH)进行治疗的有10例(联合组)。结果三组患儿在实验研究前身高差异均无统计学意义(均P>0.05),三组的成年终身高分别为(151.93±3.35)cm、(151.88±4.05)cm和(149.56±3.62)cm,实验研究后成年终身高分别为(157.06±2.01)cm、(161.35±2.43)cm和(167.75±2.15)cm,GnRHa组和联合组的身高净增长均显著大于对照组,但GnRHa组和联合组间差异无统计学意义(P>0.05)。在实验后三组患儿的预测终身高明显大于实验研究前,且GnRHa组、联合组的身高增长速度更大,实验研究前差异无统计学意义(P>0.05),而实验后差异具有统计学意义(P<0.05);使用GnRHa治疗的GnRHa组、联合组两组的骨龄增长速度明显小于未治疗的对照组,治疗前差异无统计学意义(P>0.05),治疗后差异具有统计学意义(P<0.05);对照组月经初潮年龄小于GnRHa组和联合组,女童月经来潮距离停药的时间长短除与治疗前有无月经初潮有关外,与其他所有因素均不相关。三组在实验研究后的月经初潮年龄分别为(8.54±1.60)岁、(10.53±3.22)岁、(10.86±5.84)岁,结果显示实验研究前后差异均具有统计学意义(均P<0.05)。结论 GnRHa和rhGH对女童特发性中枢性性早熟有一定的治疗效果,在使用促性腺激素释放激素类似物治疗ICPP患儿时如果出现生长速度减慢的情况,可以用rhGH辅助治疗,这对成年终身高等有一定的改善作用。
文摘目的研究促性腺激素释放激素类似物（Gn RHa）治疗过程中下丘脑-垂体-性腺轴（HPGA）抑制程度与中枢性性早熟（CPP）女童成年预测身高（PAH）的关系,以指导临床个体化调节GnRHa治疗剂量。方法收集75例CPP女童的临床资料,记录GnRHa治疗的不同时间点身高、骨龄（BA）、子宫卵巢容积及LH、FSH峰值、E2水平,计算各时间点PAH,分析PAH改善（ΔPAH=PAH-靶身高）的情况及其与HPGA抑制的关系,并采用阈值效应分析寻找ΔPAH的最佳HPGA抑制范围。结果 Gn RHa治疗后PAH较治疗初期有明显改善。ΔPAH与ΔBA呈负相关;治疗24月时ΔPAH与LH呈负相关。将子宫容积控制在2.3～3.0 m L之间,LH控制在0.8 IU/L以下,FSH控制在2.4 IU/L以下对延缓BA的增长及改善PAH有利。结论 GnRHa治疗能改善CPP女童的PAH。选择合适的Gn RHa治疗剂量,将子宫容积、LH、FSH控制在一定范围内,有利于延缓BA及改善PAH。
