特发性中枢性性早熟和特发性矮小女孩初潮后治疗方法与疗效.docVIP

特发性中枢性性早熟和特发性矮小女孩初潮后治疗方法与疗效比较 崔朝晖 王继东 无锡市儿童医院 江苏 无锡 214023） 摘 要：【目的】观察促性腺激素释放激素类似物（GnRHa）联合应用重组人生长激素（rhGH）治疗特发性中枢性性早熟（ICPP）和特发性矮小（ISS）女孩月经初潮后预测成年身高（PAH）的效果。【方法】5例ICPP女孩和7例ISS女孩分别联合应用GnRHa（80—100mg (Kg-1,每隔28-32天肌肉注射一次），rhGH(0.15 IU(Kg-1(d-1)，连续应用18个月，对其治疗前后的生长速度，按骨龄的身高标准差分值（HtSDSBA）以及PAH进行分析。【结果】联合应用后二组女孩生长速度明显加快，HtSDSBA增加，而PAH则明显延长，但两组之间的差异不明显。【结论】GnRHa 联合应用rhGH能明显加快这二组患儿的生长速度，促进身高年龄对骨龄的追赶以及改善预测成年的身高。 【关键词】月经初潮；性早熟；特发性矮小；促性腺激素释放激素；生长激素 中图分类号 R725.8 Observation of combined treatment of gonadotropin-releasing hormone analog with recombinant human growth hormone in girls with central precocious puberty and with idiopathic short stature. Cui zhao-hui Wuxi children＇s hospital Wuxi Jiangsu 214023 China Abstract:【Objective】To observe the effect of combined treatment with gonadotropin-releasing hormone analog(GnRHa) and recombinant human growth hormone (rhGH) on predicted adult height (PAH) in girls with central precocious puberty (CPP) and with idiopathic short stature (ISS) respectively.【Method】five girls with CPP, seven girls with ISS were treatmented at GnRHa 80-100mg(Kg-1 every 28 to 32days, rhGH 0.15 IU ( Kg-1( d-1, for 18months at least. Comparisons of growth velocity, hight SDS for bong age (HtSDSBA) and PAH were performened before and after the combined treatment at 12months and 18 months respectively.【Results】 During GnRHa combined with rhGH therapy growth velocity increased significantly (P ( 0.05), HtSDSBA increased and PAH prolonged significantly (P ( 0.05 – 0.001) in these two groups. But there are not any different effects between both groups. 【Conclusion】 The combined GnRHa and rhGH treatment can remarkably improve growth velocity, HtSDSBA and PAH in CPP and ISS girls. 【Key words】 menophania; precocious; idiopathic short stature; gonadodotropin-releasing hormone; growth hormone 女孩月经初潮时的年龄，以及初潮时的年龄别身高、按骨龄的身高标准差分值（HtSDSBA）与其成年后的最终身高有着密切的关系。月经初潮的来临提示青春发育已进入了中、后期，其生长高峰已经结束，生长的潜能也很有限。为了探讨青春期矮小女孩的治疗，我们联合应用促性腺激素类似物（GnRHa）和重组人生长激素（