【摘要】 目的探讨促性腺激素释放激素类似物(GnRHa)联合生长激素(rhGH)对特发性中枢性性早熟(ICPP)患儿的治疗效果及对其身高、雌二醇(E2)、黄体生成激素(LH)水平的影响。方法选取2015年1月～2017年6月东莞市妇幼保健院收治的68例ICPP女性患儿,根据用药情况不同分为实验组(35例)和对照组(33例)。对照组使用GnRHa进行治疗,实验组在对照组的基础上使用rhGH治疗,比较两组患儿治疗前后的身高、预测成年身高(PAH)、身高标准差分值(HtSDSBA)及LH、卵泡刺激素(FSH)、E2水平。结果两组治疗前的身高、PAH及HtSDSBA比较,差异无统计学意义(P>0.05)。两组治疗后的身高、PAH与HtSDSBA均高于治疗前,且实验组治疗后的身高、PAH与HtSDSBA均高于对照组,差异有统计学意义(P<0.05)。两组治疗前GnRHa激发试验60 min的LH、FSH、基础E2水平比较,差异无统计学意义(P>0.05)。两组治疗后的LH、FSH、基础E2水平均低于治疗前,且实验组治疗后的LH、FSH、基础E2水平均低于对照组,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 GnRHa联合rhGH治疗能明显改善ICPP患儿的成年预测身高和体内E2、LH水平,且药物稳定、安全性高。对于预测成年身高不理想的患儿,可以投入使用。更多还原

【Abstract】 Objective To investigate the therapeutic effect of Gonadotropin-releasing Hormone Analogue(GnRHa combined with Growth Hormone（rhGH） on children with idiopathic central precocious puberty（ICPP） and its influence on their height, estradiol（E₂） and luteinizing hormone（LH）. Methods A total of 68 cases of ICPP female children admitted to Maternal and Child Health Care Hospital of Dongguan City from January 2015 to June 2017 were selected and divided into the experimental group（35 cases） and the control group（33 cases） according to different medication conditions. The control group was treated with GnRHa, and the experimental group was treated with rhGH on the basis of the control group. The height, predicted adult height（PAH）, standard difference of height（HtSDSBA）, and the levels of LH, follicle stimulating hormone（FSH） and E₂ before and after treatment of the two groups were compared. Results There were no significant differences in height, PAH and HtSDSBA between the two groups before treatment（P>0.05）.After treatment, the height, PAH and HtSDSBA of the two groups were higher than those before treatment, which in the experimental group were higher than those in the control group, and the differences were statistically significant（P<0.05）. There were no significant differences in the levels of LH, FSH after 60 minutes of GnRHa stimulation test and base E₂ between the twol group before treatment（P>0.05）. After treatment, the levels of LH, FSH and base E₂ in the two groups were higher than those before treatment, and which in the experimental group were higher than those in the control group, with statistically significant differences（P<0.05）. There was no significant difference in the incidence rate of adverse reactions between the two groups（P>0.05）. Conclusion Gn RHa combined with rh GH can significantly improve the predicted height of ICPP children, the levels of E₂ and LH in vivo, and the drug is stable and safe. It can be put into use in children with unsatisfactory predicted adult height.更多还原