生长激素对于GnRHa治疗中生长过度减速的特发性中枢性性早熟女孩的远期疗效观察  

Final adult height in girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogue and growth hormone

作　　者：郑丕媚[1] 苏喆[1] 马华梅[1] 杜敏联[1] 陈秋莉[1] 李燕虹[1] 陈红珊[1] 

机构地区：[1]中山大学附属第一医院儿科,广州510080

出　　处：《中华内分泌代谢杂志》2011年第4期287-291,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 观察重组人生长激素（rhGH）对于促性腺激素释放激素类似物（GnRHa）治疗中生长过度减速的特发性中枢性性早熟（ICPP）女孩的最终成年身高（FAH）的影响.方法 49例ICPP女孩接受GnRHa治疗,当身高增长速度减慢至4 cm/年以下时,其中26例联用rhGH治疗为联合治疗组,23例拒绝加用rhGH但继续使用GnRHa为单用组.比较2组治疗前后的预测成年身高（PAH）和FAH.结果 联合治疗组联用rhGH前半年,身高增长速度均小于4 cm/年[（3.2±1.0）cm/年],PAH无明显改善[联用rhGH前半年和rhGH开始时PAH分别为（152.5±4.0）cm和（152.6±3.7）cm];联用rhGH（11.4±5.4）个月后,身高增长速度增加至（6.7±2.0）cm/年,PAH增加至治疗结束时的（157.1±4.7）cm（均P〈0.01）;FAH[（157.5±4.5）cm]显著高于GnRHa开始时的PAH[（148.1±4.6）cm]和遗传靶身高[（154.4±4.6）cm,均P〈0.01].单用组治疗结束时的PAH[（153.9±6.3）cm]较拒绝联用rhGH时的PAH[（153.1±6.2）cm]无差异;FAH[（154.7±5.5）cm]高于治疗开始时的PAH[（150.3±6.0）cm,P〈0.01],但与遗传靶身高[（155.6±4.3）cm]无差异.结论 联用rhGH能够显著加快GnRHa治疗中生长过度减速的ICPP女孩的身高增长速度,进一步改善PAH和FAH.Objective To evaluate the long-term final adult height outcome of combined treatment with gonadotropin-releasing hormone analogue（GnRHa）and recombinant human growth hormone（rhGH）in girls with idiopathic central precocious puberty（ICPP）.Methods Out of 49 sirls with ICPP[treated with GnRHa at a dose of 60-80 μg/kg every 4 weeks for at least 6 months,whose height velocity fell below 4 cm/year and showed no improvement of predicted adult height（PAH）in 6 months],26 received（rhGH-combined group）,in addition to chronological age,and duration of GnRHa treatment,who showed the same growth pattern but refused rhGH treatment,served to evaluate the efficacy of rhGH in addition.At the conclusion of the smdy,all the girls had been followed up for（3.3±1.9）years,and（3.2±0.9）years in rhGH-combined group and control group,respectively;and had achieved adult heisht.To compare the PAH with the final adult height（FAH）before and after treatment in the two groups.Results During rhGH treatment, height velocity of the rhGH-combined girls increased significantly[（6.7±2.0 vs 〈4）cm/year baseline],RhGH-combined gids showed an adult height far higher than pretreatment PAH [（157.5±4.5 vs 148.1±4.6）cm,P〈0.01],and target height[（154.4±4.6）cm] was,significantly excceded.The control group reached an adult heisht also significandy higher than pretreatment PAH[（154.7±5.5vs 150.3±6.0）cm,P〈0.01],while target height[（155.6±4.3）cm]was just reached but not significantlyexcceded.The gain in height obtained,calculated between pretreatment PAH and final heisat,（9.4±4.9）cm in rhGH-combined group was much more than that（4.3±4.2）cm in the control group（P〈0.01）.Conclusion RhGH may accelerate the linear growth and improve adult height of GnRHa-treated ICPP girls.

关 键 词：促性腺激素释放激素类似物 生长激素 青春期 早熟 成年身高 

分 类 号：R725.8[医药卫生—儿科]