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目的观察促性腺激素释放激素类似物(Gn RHa)联合司坦唑醇(ST)对改善女性特发性中枢性性早熟患儿(ICPP)成年身高(FAH)的效果。方法 60例ICPP女孩分为两组:组1 Gn RHa联合ST(32例),组2单独使用Gn RHa(28例)。比较各组HV、BA/年龄增长比值(ΔBA/ΔCA)及FAH。结果组1在入组治疗期间的HV显著高于入组治疗前[(6.24±1.84)cm/年和(2.81±0.55)cm/年,P<0.05],组2的HV与入组治疗前相比,差异无统计学意义[(3.38±0.89)cm/年和(3.98±1.12)cm/年,P>0.05]。两组ΔBA/ΔCA分别为0.24(0.10~0.29)、0.21(0.10~0.33),差异无统计学意义(P>0.05)。组l的FAH为(156.42±2.89)cm,高于入组治疗前预测成年身高[(151.45±3.62)cm,P<0.05]及遗传靶身高[(154.87±2.71)cm,P<0.05]。组2的FAH与入组治疗前预测成年身高差异无统计学意义[(153.79±2.57)cm和(152.58±5.41)cm,P>0.05],且低于遗传靶身高[(155.49±4.36)cm,P<0.05]。两组无人出现多毛、嗓音粗、阴蒂肥大等表现。结论 ICPP女孩在接受Gn RHa治疗过程中,间歇、小剂量应用ST治疗可显著提高HV而不加速BA,有效改善FAH,且未见明显不良反应。
Objective To observe the effect of Gn RHa combined with stanozolol (STn) on improving adult height (FAH) in female idiopathic central precocious puberty (ICPP). Methods Sixty ICPP girls were divided into two groups: group 1 Gn RHa combined with ST (n = 32) and group 2 Gn RHa alone (n = 28). The HV, BA / age ratio (ΔBA / ΔCA) and FAH of each group were compared. Results The HV of group 1 was significantly higher than that of group before treatment [(6.24 ± 1.84) cm / year and (2.81 ± 0.55) cm / year, P <0.05] (3.38 ± 0.89) cm / year and (3.98 ± 1.12) cm / year respectively, P> 0.05]. The ΔBA / ΔCA values of the two groups were 0.24 (0.10-0.29) and 0.21 (0.10-0.33) respectively, with no significant difference (P> 0.05). The FAH of group I was (156.42 ± 2.89) cm, which was higher than the predicted height of adult before treatment [(151.45 ± 3.62) cm, P <0.05] and genetic target height [(154.87 ± 2.71) cm, P <0.05). There were no significant differences in FAH between the two groups before treatment ([(153.79 ± 2.57) cm and (152.58 ± 5.41) cm, P> 0.05], and lower than the genetic target height [(155.49 ± 4.36) cm , P <0.05]. No hairy two groups, thick voice, clitoral hypertrophy and other performance. Conclusion ICPP girls receiving Gn RHa treatment, intermittent, low-dose ST treatment can significantly improve the HV without accelerating BA, effectively improve the FAH, and no significant adverse reactions.