早初潮及GnRHa治疗对月经规则性的影响  

Menstrual regularity among early menarche girls and girls treated with GnRHa

作　　者：陈秋莉[1] 李燕虹[1] 陈红珊[1] 张军[1] 马华梅[1] 杜敏联[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》2015年第9期774-777,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的：探讨早初潮及促性腺激素释放激素类似物（ GnRHa）治疗对初潮后月经规则性的影响。方法抽取初潮后610名健康体检的中学女生，并追踪曾应用GnRHa治疗的169例中枢性性早熟（ CPP）或快速进展型早发育（ EFP）、且已呈现初潮的女孩，询问两组的月经规则情况。结果610名健康女孩中月经不规则者129例（21.1%），其中44名早初潮者中，不规则者10例（22.7%），迟初潮44名中不规则者11例（25.0%），早初潮和迟初潮者与正常初潮者不规则比例（17.2%）比较，差异均无统计学意义。正常初潮者和早初潮者痛经比例分别为41.1%和50%，二者无差异。接受GnRHa治疗的CPP（113例）和EFP（56例）女孩，月经不规则者53例（31.4%），不规则比例较健康组为高（P〈0.05），但与早初潮组相比无统计学差异；痛经者57例（33.7%），与早初潮者及正常初潮者痛经比例均无差异。结论健康女孩早初潮者月经不规则率与正常初潮者相比无明显差异。 GnRHa治疗者月经不规则率较正常人群显著增高，但与早初潮者无差异。早初潮和GnRHa治疗对痛经的发生率均无影响。Objective To assess the effect of early menarche and treatment with gonadotropin-releasing hormone analogs （ GnRHa ） in girls with central precocious puberty （ CPP ） or early and fast puberty （ EFP ） on menstrual regularity. Methods Six hundred and ten healthy girls were recruited and their menarche age and menstrual cycle were recorded. 169 CPP or EFP girls treated with GnRHa were followed up, and their menarche age and menstrual cycle were also recorded. Results There were 129 girls with irregular menstruation among 610 healthy girls（21. 1%）, with 10 in 44 early menarche girls（22. 7%） and 11 in 44 late menarche girls（25. 0%）. Compared with normal menarche girls（17. 2%）, no significant difference was found in the incidences of irregular menstruation in early and late menarche girls. The incidences of dysmenorrhea were 41. 1% in normal girls and 50. 0% in early menarche girls, without significant difference. There was a higher incidence of irregular menstruation in 113 CPP girls and 56 EFP girls treated with GnRHa compared with healthy girls （31. 4% vs 21. 1%, P〈0. 05）, but without difference compared with early menarche girls（P〉0. 05）. Fifty-seven cases treated with GnRHa（33. 7%） suffered from dysmenorrhea, and there was no significant difference as compared with healthy girls and girls with early menarche. Conclusion The incidence of irregular menstruation was similar in early menarche girls and normal girls. CPP and EFP girls with GnRHa treatment had a significantly higher incidence of irregular menstruation than normal girls, but no difference was found as compared with girls with early menarche. Early menarche and GnRHa treatment did not affect the incidence of dysmenorrhea.

关 键 词：早初潮 中枢性性早熟 快速进展型早发育 促性腺激素释放激素类似物 月经规则性 

分 类 号：R711.51[医药卫生—妇产科学]