每六周皮下注射促性腺激素释放激素类似物缓释剂干预女孩特发性中枢性性早熟  

Clinical study of subcutaneous administration of gonado tropin-releasing hormone agonist every six weeks in girls with idiopathic centr al precocious puberty

作　　者：梁雁[1] 魏虹[1] 张建玲[1] 侯凌[1] 罗小平[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉430030

出　　处：《中华儿科杂志》2004年第11期845-849,共5页Chinese Journal of Pediatrics

摘　　要：目的　观察延长促性腺激素释放激素类似物 (GnRHa)缓释剂注射间期对特发性中枢性性早熟女孩下丘脑 垂体 性腺轴抑制情况和临床症状改善方面的效果。方法　 4 6例特发性中枢性性早熟女孩随机分为两组 ,A组 :2 6例 ,年龄 (8 3± 1 4 )岁 (6 1～ 11 2 )岁 ,乳房开始发育年龄 (6 6±1 4 )岁 (2～ 8)岁 ,骨龄 (8 9± 1 5 )岁 (6 8～ 11 5 )岁 ;每 6周腹部皮下注射曲普瑞林 3 75mg ,平均剂量为 2 8± 0 6 (1 8～ 4 1) μg/ (kg·d) ;B组 :2 0例 ,年龄 (8 1± 1 3)岁 (5 1～ 10 3)岁 ,乳房开始发育年龄 (7 0± 1 2 )岁 (4～ 8)岁 ,骨龄 (8 9± 1 4 )岁 (6～ 11 5 )岁 ;每 4周肌肉注射曲普瑞林 3 75mg,平均剂量为 4 8± 1 1(3 2～ 7 4 ) μg / (kg·d)。两组均连续用药 1年以上。治疗过程中注意监测以下指标 :性发育情况、身高、体重、生长速率、血性激素的水平、骨龄等。结果　每 6周皮下注射曲普瑞林3 75mg的治疗方案与每 4周肌肉注射普瑞林 3 75mg的治疗方案均能使患儿的第二性征减退、停止发育 ,乳房发育明显受到抑制 ,乳腺回缩或乳腺组织变松软 ;卵巢体积缩小 ,直径大于 0 4cm的卵泡消失 ;促性腺激素分泌减少 ,性激素下降至青春前期水平 ;A、B两组的年生长速率 (cm/年 )分别由治疗前的 6Objective Gonadotropin-rel ea sing hormone agonist (GnRHa) is widely used for the treatment of precocious pube rty, but there was no identical regime for the dosage and the interval of admini stration. The aim of this study was to assess the feasibility of subcutaneous a dministration of Triptorelin with a prolonged interval (six weeks) for the suppr ession of pituitary-gonadal axis and clinical signs in girls with idiopathic ce ntral precocious puberty (ICPP). Methods Forty-six girl s with ICPP were enrolled in this trial and were divided into two groups at rand om, with 26 patients in group A and 20 in group B. There were no significantly differences in chronological age, height, weight, age at clinical onset of puber ty and bone age between the two groups before trteatment. Triptorelin (Decapept yl, 3.75mg) was administered subcutaneously (SC) at 6 weeks intervals in group A or intramuscularly (IM) at 4 weeks intervals in group B. Both forms were giv en for more than 12 months consecutively. During the period of treatment, the c linical parameters including height, weight, pubertal stage, bone age, uterine v olume and ovarian size were documented. The serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E 2) were monitored us ing immunoenzymometric assay. Results Both treatment reg imes can completely suppressed the pituitary-gonadal axis. The clinical signs of pubertal development regressed or stabilized in all patients. Breast develop ments, as reflected by Tanner staging, were regressed. Uterine volume de creased after treatment, however, this decrease did not reach statistical significance . Mean ovarian volume did not change significantly during treatment. The heigh t velocity was significantly decreased from a pretreatment value of 6.3±1.4 c m/year to 5.8±1.2 cm/year in group A and 6.7±1.3 cm/year to 5.4±1.0 cm/ year in group B, respectively. The rate of skeletal maturation was reduced sign ificantly during treatment. The ratio of bone age/chronologica

关 键 词：皮下注射 骨龄 肌肉注射 治疗前 曲普瑞林 特发性中枢性性早熟 促性腺激素释放激素类似物 ABA 回缩 生长速率 

分 类 号：R725.8[医药卫生—儿科]