促性腺激素释放激素类似物与生长激素联用治疗真性性早熟女孩的疗效评价.docVIP

促性腺激素释放激素类似物与生长激素联用治疗真性性早熟女孩的疗效评价?252?泌代谢杂志2006年6月第22卷第3期ChinJ垦!ab』:丝::?临床研究促性腺激素释放激素类似物与生长激素联用治疗真性性早熟女孩的疗效评价马华梅杜敏联李燕虹苏结陈红珊【摘要】目的评价促性腺激素释放激素类似物(GnRHa)联用重组人生长激素(rhGH)治疗对于改善真性性早熟(CPP)女孩预测成年身高(PAH)的疗效.方法对已接受GnRHa治疗6个月以上,治疗中生长速度显着减慢至4cm/年以下的15例CPP女孩,予联用rhGH(1u?kg～?W)治疗4个月以上(4～l3个月),对联用rhGH前后的生长速度,按骨龄的身高标准差分值(HtSDS)以及PAH进行比较.结果联用rhGH后生长速度较联用前6个月显着加快[(7.4_4-1.7)cm/年fJS(3.2_4-0.7)cm/年,Plt;0.01];其中7例联用rhGH9个月以上者,联用第二个6个月的生长速度较第一个6个月[(6.54-1.0)cm/年fJS(8.84-1.1)cm/年]稍减慢,但仍显着快于联用前[(3.24-0.8)cm/年].经疗程较正,联用rhGH后的每半年HtSDSB^的增加显着大于联用前[(0.354-0.15)(0.124-0.18),Plt;0.01];联用rhGH后每6个月的PAH改善亦较联用前[(3.24-1.4)cm(1.44-1.1)cm,Plt;0.01]显着增加.结论联用rhGH能显着加快GnRHa治疗中生长过慢的真性性早熟女孩的生长速度,促进身高年龄对骨龄的追赶以及改善预测成年身高.【关键词】青春期,早熟;促性腺激素释放激素;生长激素Evaluationofcombinedtreatmentofgonadotropin-releasinghormoneanalogwithrecombinanthumangrowthhormoneingiftswithcentralprecociouspubertyMAHua—rnei,DUMin—lian,UYan-hong,SUZhe,CHENHong-shan.PediatricDepartmentofTheFirstHospitalAffiliatedtoZhongshanUniversity.Guangzhou510O80【Abstract】0bjectiveToevaluatetheeffectofcombinedtreatmentwithgonadotropin—releasinghormoneanalog(GnRHa)andrecombinanthumangrowthhormone(rhGH)onpredictedadultheight(PAH)ingirlswithcentralprecociouspuberty(CPP).MethodsFifteengirlswithCPP,whosegrowthvelocityduringGnRHatreatmenthadbeenlessthan4cm/year.weregiyenadditionalrhGHtreatmentatadoseoflU?kg一?W～,SC,f0r4—13months.Comparisonsofgrowthvelocity,heightSDSforboneage(HtSDSB^)andPAHwereperformedbeforeandafterthecombinedtreatment.ResultsDuringrhGHcombinedwithGnRHatherapy,growthvelocityincreasedsignificantly[(7.44-_1.7)cm/yearfJS(3.24-0.7)cm/yearbaseline,Plt;0.01].In7girlstreatedwithrhGHandGnRHaformorethan9months,growthvelocityinthesecond6months[(6.54-1.0)cm/year]wass1iglltlylowerthanthatinthefirst6months[(8.84-1.1)cm/year],beingbothfasterthanthatofbaseline[(3.24-0.8)cm/year].ThereWasasignificantincreaseinrhGH—durationcorrectedchangeofHtSDSa^[(0.354-0.15)/6monthfJS(0.124-0.18)/6monthbaseline,Plt;0.01]andPAH[(3.24-1.4)cm/6monthfJS(1.44-1.1)cm/6monthbaseline,Plt;0.