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目的探讨促性腺素释放激素激动剂治疗中枢性性早熟患儿的临床效果。方法 100例中枢性性早熟患儿,给予醋酸曲普瑞林50~100μg/kg肌内注射,每4周1次,疗程4个月。比较治疗前及治疗后6、12、24、36个月患儿骨龄差值/身高差值(△BA△CA)、骨龄(bone age,BA)、生长速率(growth velocity,GV)及预测身高(predicted adult height,PAH)的变化。结果(1)治疗后6、12、24、36个月,患儿△BA△CA(0.86±0.41、0.71±0.31、0.52±0.30、0.28±0.22)、BA[(11.05±0.76)、(11.24±0.98)、(11.45±1.02)、(11.99±1.76)岁)]、PAH[(152.16±3.56)、(153.21±4.01)、(154.23±4.23)、(156.34±5.08)cm]、GV[(7.78±1.31)、(6.56±1.29)、(5.21±1.17)、(4.50±1.01)cm/a]与治疗前[10.56±0.98、(10.30±0.89)岁、(149.41±4.18)cm、(9.01±1.38)cm/a]比较差异均有统计学意义(P<0.05),且不同时间点△BA△CA、BA、PAH、GV比较差异均有统计学意义(P<0.05);(2)治疗后患儿性发育症状发生率较治疗前改善(P<0.05);(3)治疗4个月,患儿子宫容积[(2.89±1.11)mL]、卵巢容积[(1.67±1.21)mL]较治疗前[(4.57±1.60)、(2.27±1.23]mL)缩小,促黄体生成素峰值[(14.67±2.89)u/L]、卵泡刺激素[(3.21±1.62)u/L]均较治疗前[(19.67±8.82)、(5.28±2.78)u/L]降低,差异有统计学意义(P<0.05);(4)治疗期间未发生严重并发症和药物不良反应。结论醋酸曲普瑞林治疗中枢性性早熟安全、有效,可延缓患儿生长速率,提高预测身高,有助于改善成人最终身高。
Objective To investigate the clinical effects of gonadotropin-releasing hormone agonist on children with central precocious puberty. Methods 100 cases of children with central precocious puberty were given triptorelin acetate 50 ~ 100μg / kg intramuscularly once every 4 weeks for 4 months. The difference of bone age / height difference (△ BA △ CA), bone age (BA), growth velocity (GV) and predicted height before and 6, 12, 24 and 36 months after treatment were compared (predicted adult height, PAH) changes. Results (1) At 6, 12, 24 and 36 months after treatment, there were no significant differences in △ BA △ CA (0.86 ± 0.41,0.71 ± 0.31,0.52 ± 0.30,0.28 ± 0.22), BA [(11.05 ± 0.76) PAH 152.16 ± 3.56 153.21 ± 4.01 154.23 ± 4.23 156.34 ± 5.08 cm], GV [(P <0.98), (11.45 ± 1.02) and (11.99 ± 1.76) (10.56 ± 0.98, (10.30 ± 0.89) years, (149.41 ± 4.18) cm, (9.01 ± 1.18), (5.12 ± 1.17) and (4.50 ± 1.01) cm / ± 1.38 cm / a] (P <0.05), and the differences of △ BA △ CA, BA, PAH and GV at different time points were statistically significant (P <0.05); (2) (3) After 4 months of treatment, the uterine volume (2.89 ± 1.11) mL and ovarian volume [(1.67 ± 1.21) mL] were significantly higher in treatment group than those before treatment (P <0.05) (14.67 ± 2.89) u / L] and follicle stimulating hormone [(3.21 ± 1.62) u / L] compared with those before treatment [(4.57 ± 1.60) vs (2.27 ± 1.23) mL] Before treatment [(19.67 ± 8.82), (5.28 ± 2.78) u / L], the difference was statistically significant (P <0.05); (4) No serious complications and adverse drug reactions occurred during the treatment. Conclusion Triptorelin acetate is safe and effective in treating central precocious puberty, which can delay the growth rate of children and improve the predicted height, which will help to improve the final adult height.