促性腺激素释放激素类似物治疗特发性中枢性性早熟女童体质变化的长期随访研究  

Long-term Follow-up of Girls with Idiopathic Central Precocious Puberty Treated with GonadotropinReleasing Hormone Analogs

作　　者：蔡锡顶[1] 白敏[1] 李珍[1] 顾承萍[1] 

机构地区：[1]浙江省舟山市妇幼保健院,浙江舟山316000

出　　处：《儿科药学杂志》2014年第6期9-11,共3页Journal of Pediatric Pharmacy

基　　金：浙江省舟山市科技局项目;编号:2012C13031

摘　　要：目的：通过对24例特发性中枢性性早熟（ICPP）女童应用促性腺激素释放激素类似物（GnRHa）治疗至少2年的定期随访,调查患儿体质指数（BMI）的变化及肥胖发生率。方法：以2006-2010年在我院确诊并以GnRHa治疗至少2年的24例ICPP女童为研究对象。在应用GnRHa治疗期间每3~6个月复查一次GnRH激发试验,使促性腺激素及性激素水平均抑制在发育前水平,随访患儿年龄、骨龄、身高、体质量、BMI变化情况。结果：治疗前,8.33%（2/24）ICPP女童BMI超过1个标准差分数（SDS）,视为超重,无一例ICPP女童BMI超过2个SDS;治疗结束后,2例原有超重的ICPP女童BMI-SDS仍超过1个SDS,但未达到2个SDS;治疗期间平均BMI-SDS无明显变化,每个患儿的BMI-SDS均未明显增加（P〉0.05）。治疗结束后的BMI-SDS与治疗前呈正相关（r=0.35,P〈0.01）。结论：ICPP女童应用GnRHa治疗不会引起BMI增加,而原有超重或肥胖的性早熟患儿仍会按原有轨迹发展,需警惕其可能发展为成人肥胖症。Objective： To investigate body mass index （BMI） evolution and obesity prevalence in twenty-two girls with idiopathic central precocious puberty （ICPP） who were treated with gonadotropin-releasing hormone agonists （GnRHa） for at least two years. Methods： Twenty-four ICPP patients from 2006 to 2010 treated with GnRHa for at least two years were selected for this study. Age, bone age, height-SDS, weight-SDS, BMI-SDS, pubertal staging and LH and FSH levels after standard GnRH test were evaluated every three to six months during treatment to assess the suppression of the pituitary-gonadal axis. Results： At the start of therapy, 8.3 % （2/24） of the ICPP girls had a BMI exceeding 1 standard deviation scores （SDS） and were therefore classified as overweight. Nobody had a BMI exceeding 2 SDS. The two overweight patients were still had a BMI exceeding 1 SDS, but not reached 2 SDS at the end of therapy. During the therapy period, the average BMI-SDS increased slightly, but did not achieve statistical relevance. None of the patients＇ BMI-SDS was increased. Pearson＇ s test showed BMI-SDS at the end of treatment was positively associated with BMI-SDS at entry （r=0.35, P〈0. O1 ）. Conclusions： Girls with ICPP who were treated with GnRHa do not appear to BIM increased. It should be counseled that obesity or overweight patients maybe become adult obesity.

关 键 词：促性腺激素释放激素类似物 特发性 中枢性 性早熟 体质指数 

分 类 号：R725.8[医药卫生—儿科]