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目的观察曲普瑞林治疗特发性中枢性性早熟的临床疗效。方法对200例特发性中枢性性早熟患儿均采用曲普瑞林治疗,初治剂量100μg.kg-1,自第4个月起减量至60～80μg.kg-1,每4周注射1次,治疗12～36(21.10±7.43)个月。观察200例患儿治疗前,治疗后6、12、24、36个月的骨龄(BA)、生长速率(GV)及身高(PAH)的变化等情况。结果治疗后BA的增长低于年龄的增长。年龄为(9.31±1.13)、(9.89±1.06)(、10.41±1.13)、(11.02±1.21)岁的患儿:治疗前BA为(10.63±1.05)岁,治疗后6、12、24、36个月BA分别为(11.01±0.98)、(11.42±1.01)(、11.75±1.12)、(11.98±1.07)岁,二者比较差异均有统计学意义(均P<0.01);治疗前△BA/△CA比值为1.73±0.25,治疗后6、12、24、36个月△BA/△CA比值分别为0.86±0.39、0.61±0.28、0.48±0.32、0.22±0.26,二者比较差异均有统计学意义(均P<0.01);治疗前GV为(8.50±1.43)cm.a-1,治疗后6、12、24、36个月GV分别为(6.70±1.26)、(6.40±1.25)、(5.30±1.38)、(4.50±1.32)cm.a-1,二者比较差异均有统计学意义(均P<0.01);治疗前PAH为(151.26±4.63)cm,治疗后6、12、24、36个月PAH分别为(152.29±3.91)、(153.13±4.33)、(154.58±5.09)、(156.31±5.34)cm,二者比较差异均有统计学意义(均P<0.01)。结论曲普瑞林能有效地抑制特发性中枢性性早熟的性征发育和骨龄的增长,改善成年身高。
Objective To observe the clinical efficacy of triptorelin in the treatment of idiopathic central precocious puberty. Methods 200 patients with idiopathic central precocious puberty were treated with triptorelin, the initial dose of 100μg.kg-1, from the 4th month reduced to 60 ~ 80μg.kg-1 every 4 weeks 1 injection, treatment 12 ~ 36 (21.10 ± 7.43) months. The changes of bone age (BA), growth rate (GV) and height (PAH) were observed before treatment, 6,12,24,36 months after treatment in 200 children. Results After treatment, the growth of BA was lower than that of age. (9.31 ± 1.13), (9.89 ± 1.06), (10.41 ± 1.13), (11.02 ± 1.21) years old children before treatment: BA was (10.63 ± 1.05) years old, after treatment, 6,12,24,36 Months were (11.01 ± 0.98), (11.42 ± 1.01), (11.75 ± 1.12), (11.98 ± 1.07) years respectively, with significant difference between the two groups (all P <0.01) / △ CA ratio was 1.73 ± 0.25, and the △ BA / △ CA ratios at 6, 12, 24 and 36 months after treatment were 0.86 ± 0.39,0.61 ± 0.28,0.48 ± 0.32 and 0.22 ± 0.26, respectively GV was (6.70 ± 1.26), (6.40 ± 1.25) days after treatment, respectively (P <0.01). The GV before treatment was (8.50 ± 1.43) , (5.30 ± 1.38) and (4.50 ± 1.32) cm.a-1, respectively, with significant difference between the two groups (all P <0.01); PAH was (151.26 ± 4.63) cm before treatment, (152.29 ± 3.91), (153.13 ± 4.33), (154.58 ± 5.09) and (156.31 ± 5.34) cm at 24 and 36 months respectively. There was significant difference between the two groups (all P <0.01). Conclusion Triptorelin can effectively inhibit the development of idiopathic central precocious puberty and the growth of bone age and improve the height of adulthood.