| 王淑琴,薛颖,高怡青,等.单用促性腺激素释放激素类似物及联合重组人生长激素治疗对月经初潮后特发性中枢性性早熟女童身高的影响[J].安徽医药,2024,28(8):1650-1655. |
| 单用促性腺激素释放激素类似物及联合重组人生长激素治疗对月经初潮后特发性中枢性性早熟女童身高的影响 |
| Effect of GnRHa alone and rhGH combined treatment on height of children with idiopathic central precocious puberty in girls after menarche |
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| DOI：10.3969/j.issn.1009-6469.2024.08.036 |
| 中文关键词: 青春期，早熟 女童初潮 特发性中枢性性早熟 促性腺激素释放激素类似物 重组人生长激素 接近成年终身高 |
| 英文关键词: Puberty, precocious Girl menarche Idiopathic central precocious puberty Gonadotropin-releasing hormone ana-logs Recombinant human growth hormone Near final adult height |
| 基金项目:徐州市卫生健康委科技项目面上项目( XWKYHT20200033) |
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| 中文摘要: |
| 目的探讨促性腺激素释放激素类似物( GnRHa)联合重组人生长激素( rhGH)单用 GnRHa治疗对有月经初潮的特发性中枢性性早熟( ICPP)女童身高的影响。方法回顾性分析 2014年 1月至 2020年 12月，于徐州医科大学附属徐州儿童医院儿童生长发育门诊就诊 76例有月经初潮的 ICPP女童为研究对象，根据治疗方案分为治疗对照组( n=22)单用 GnRHa治疗组(n=22)和 GnRHa联合 rhGH治疗组( n=32)随访观察至接近成年终身高( near final adult height，NFAH)，比较，三组病儿 NFAH、身高净生长( ΔHt)、遗传增高( NFAH-遗传身高，)。结果对照组、 GnRHa组、联合用药组三组就诊基线身高、体质量、身体质量指数(BMI)、骨龄、遗传靶身高差异无统计学意义(P>0.05)随访 NFAH分别( 158.27±3.63)cm、(159.61±3.91)cm、(162.61±3.34) cm，ΔHt分别( 12.66±3.54)cm、(13.49±3.06)cm、(16.79±3.17)c，m，遗传增高分别( -2.32±3.82)cm、(0.16±3.46)cm、(3.52±4.62) cm，三组间均差异有统计学意义( P<0.05)，其中联合用药组与 GnRHa组、对照组比较均差异有统计学意义( P<0.05)； GnRHa组和对照组在遗传增高方面差异有统计学意义(P<0.05)，在 NFAH、ΔHt方面比较均差异无统计学意义(P>0.05)。结论对已有月经初潮的 ICPP女孩， GnRHa联合 rhGH治疗，可改善 NFAH，但需权衡治疗成本及身高获益，临床应谨慎推荐，单用 GnRHa治疗不改善 NFAH，可改善遗传增高。 |
| 英文摘要: |
| Objective To investigate the effect of recombinant human growth hormone (rhGH) combined with gonadotropin-releasing hormone analogs (GnRHa), GnRHa therapy alone on the improvement of height in idiopathic central precocious puberty (ICPP) girls with menarche.Methods Retrospective analysis was performed on 76 ICPP girls with menarche from January 2014 to December 2020 who visited the Child Growth and Development Clinic from the Affiliated Xuzhou Children's Hospital of Xuzhou Medical University.According to the treatment, the children were divided into untreated control group (n=22), GnRHa alone treatment group (n=22) and GnRHa combined with rhGH treatment group (n=32). Near final adult height (NFAH), net growth of height (ΔHt) and genetic increase(NFAH-genetic height) were compared among the three groups.Results There were no statistically significant differences in baseline height, BMI, bone age and genetic target height among the three groups (P>0.05). In the control group, GnRHa group and the combined treatment group, NFAH were (158.27±3.63) cm, (159.61±3.91) cm, (162.82±3.53) cm. ΔHt were (12.66±3.54) cm, (13.49±3.06) cm,(16.79±3.17) cm and the genetic increase were (-2.32±3.82) cm, (0.16±3.46) cm, ( 3.52±4.62) cm, respectively. The differences were statistically significant among the three groups(P<0.05). There were statistical significance between the combination group and the oth-er two groups (P<0.05).There was statistical difference in genetic increase between GnRHa group and control group (P<0.05), but no statistical difference in NFAH and ΔHt group (P>0.05). Conclusions For ICPP girls with menarche, GnRHa combined with rhGH treatment can improve NFAH. However, the treatment cost and height benefit should be weighed, and clinical recommendation should be cautious. GnRHa alone can not improve the NFAH, but can improve the genetic height. |
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