国产促性腺激素释放激素类似物治疗特发性中枢性性早熟女孩的疗效及安全性评价.docVIP

国产促性腺激素释放激素类似物治疗特发性中枢性性早熟女孩的疗效及安全性评价 　　摘 要 目的：评价国产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）女孩的疗效及安全性。方法：入组35例ICPP女孩，年龄（8.17±2.01）岁，治疗采用国产注射用亮丙瑞林缓释微球。观察治疗6个月后患儿身高、第二性征变化、骨龄增长情况、体重指数，以及子宫卵巢变化、卵泡刺激素、黄体生成素、雌二醇变化，分析年龄、骨龄的身高标准差分值（HtSDSCA，HtSDSBA），评价治疗效果及治疗过程中出现的不良反应。结果：35例患儿经GnRHa治疗6个月骨龄显著受抑，预测成年身高增高；血清卵泡刺激素、黄体生成素、雌激素水平降低至青春前期水平；乳房回缩，4例月经初潮患者在治疗后月经暂停来潮。用药过程中未观察到明显不良反应，用药后患者体重指数无明显变化。结论：国产GnRHa能有效抑制性征发育和骨龄增长，能减少ICPP女孩骨龄-年龄间差距而改善预测成年身高，且更经济实用，适合临床推广。 　　关键词 促性腺素释放激素类似物 中枢性性早熟 身高 体重指数 　　中图分类号：R977.12； R585 文献标识码：B 文章编号：1006-1533（2014）15-0021-04 　　Evaluation of the efficacy and safety of domestic gonadotropin releasing hormone analogue in the treatment of girls with idiopathic central precocious puberty 　　XI Li*， ZHAO Zhuhui， CHENG Ruoqian， LUO Feihong** 　　（Department of Pediatric Endocrinology and Inborn Metabolic Diseases， 　　Children’s Hospital of Fudan University， Shanghai 201102， China） 　　ABSTRACT Objective： To evaluate the efficacy and safety of domestic gonadotropin releasing hormone analogue （GnRHa） in the treatment of girls with idiopathic central precocious puberty （ICPP）. Methods： Thirty-five ICPP girls （average age 8.17±2.01 years） who received the therapy of delayed release leuprorelin acetate microspheres for injection were enrolled. The changes of body height， secondary sex characters， bone age， body mass index， uterus and ovaries， and the serum level of FSH， LH and E2 were observed after 6 months of GnRHa treatment. Height standard deviation scores （SDS） for both chronological age （HtSDSCA） and bone age （HtSDSBA） were analyzed. Adverse reactions during treatment were evaluated. Results： Bone ages of 35 ICCP girls were significantly suppressed after 6 months of treatment. HtSDSCA， HtSDSBA and predict adult heights （PAH） were increased. The serum level of FSH， LH and E2 decreased to the prepubertal level. Breasts sizes were significantly reduced and 4 cases with menarche represented amenorrhea. No significant adverse reactions were observed during the treat