摘要
目的观察不同剂量生长激素联合促性腺激素释放激素类似物(GnRHa)治疗特发性中枢性性早熟(ICPP)女童的疗效。方法选取84例ICPP女童作为研究对象,根据随机数字表法分为大剂量组和小剂量组,每组42例,2组均给予GnRHa皮下注射,小剂量组采取0.15 U/(kg·d)生长激素注射治疗,大剂量组采取0.20 U/(kg·d)生长激素注射治疗。比较2组患儿治疗前后发育指标、性激素[黄体生成素(LH)、雌二醇(E2)和卵泡刺激素(FSH)]、子宫和卵巢容积、血清血清胰岛素样生长因子-1(IGF-1)和重组人胰岛素生长因子结合蛋白-3(IGFBP-3)水平,记录2组不良反应发生情况。结果治疗6个月,2组骨龄成熟速度、LH水平、E2水平、FSH水平、血清IGF-1和IGFBP-3水平均较治疗前降低,子宫以及左侧、右侧卵巢容积较治疗前减小,生长速度及预测成年身高均较治疗前升高,差异有统计学意义(P<0.05),但2组以上指标组间比较,差异无统计学意义(P>0.05)。小剂量组总不良反应发生率为7.14%,大剂量组为16.67%,但2组差异无统计学意义(P>0.05)。结论0.15 U/(kg·d)与0.20 U/(kg·d)剂量生长激素联合GnRH-a治疗女童ICPP,均可有效促进患儿生长发育,调节性激素水平,减小子宫和卵巢体积,但0.15 U/(kg·d)剂量生长激素不良反应少,同等获益效果下优先推荐小剂量生长激素治疗。
Objective To observe the efficacy of different dosages of growth hormone combined with gonadotropinreleasing hormone analogue(GnRHa)in the treatment of girls with idiopathic central precocious puberty(ICPP).Methods A total of 84 girls with ICPP were selected as research subjects and were divided into high-dose group and low-dose group according to the random number table method,with 42 cases in each group.Patients of both groups were given subcutaneous injection of GnRHa,and the low-dose group was given 0.15 U/(kg·d)dose injection of growth hormone,and the high-dose group was treated with 0.20 U/(kg·d)dose injection of growth hormone.The developmental indicators,sex hormones[luteinizing hormone(LH),estradiol(E 2),folliclestimulating hormone(FSH)],uterine and ovarian volumes and serum levels of insulin-like growth factor 1(IGF-1)and insulin growth factor binding protein-3(IGFBP-3)were compared between the two groups before and after treatment,and the occurrence of adverse reactions in the two groups were recorded.Results At 6 months of treatment,the bone age maturation speed,levels of LH,E 2 and FSH,and levels of serum IGF-1 and IGFBP-3 were decreased in both groups,uterine,left and right ovarian volumes were decreased,and the growth rate and predicted adult height were increased compared with the treatment before(P<0.05),but there were no statistical betweengroup differences in above indicators(P>0.05).The total incidence rate of adverse reactions was 2.38%in lowdose group and 11.90%in high-dose group(P>0.05).Conclusion Both 0.15 U/(kg·d)and 0.20 U/(kg·d)doses of growth hormone combined with GnRHa can effectively promote the growth and development of girls with ICPP,regulate the levels of sex hormones and reduce the uterine and ovarian volumes,but 0.15 U/(kg·d)dose of growth hormone has fewer adverse reactions,thus low-dose growth hormone therapy is preferred for the same benefit.
作者
罗宁
徐建
LUO Ning;XU Jian(Department of Pediatrics,Meishan Second People′s Hospital of Sichuan Province,Renshou County People′s Hospital,Meishan,Sichuan,620500)
出处
《实用临床医药杂志》
2023年第21期131-134,138,共5页
Journal of Clinical Medicine in Practice
关键词
生长激素
特发性中枢性性早熟
性激素
促性腺激素释放激素类似物
growth hormone
idiopathic central precocious puberty
sex hormones
gonadotropin-releasing hormone analogue
