促性腺激素释放激素类似物对特发性中枢性性早熟女童促生长素轴与生长速度的影响  

Effects of gonadotropin-releasing hormone analogue on relationship between somatotropin axis function and growth velocity of girls with idiopathic central precocious puberty

作　　者：林翠兰[1] 韦婉俭[1] 何婉懿[1] 刘玉玲[1] 

机构地区：[1]南方医科大学附属中山市博爱医院儿科,广东中山528403

出　　处：《中国儿童保健杂志》2016年第1期65-68,共4页Chinese Journal of Child Health Care

摘　　要：目的探讨促性腺激素释放激素类似物(GnRHa)治疗女童特发性中枢性性早熟(ICPP)对促生长素轴功能与生长速度关系的影响,为GnRHa治疗后出现的生长减速寻找新的治疗方法提供理论依据。方法对接受GnRHa治疗的27例ICPP女童,观察在治疗开始以及治疗1年后其身高、骨龄、血清胰岛素样生长因子I(insulin-like growth factor-1,IGF-I)以及胰岛素生长因子结合蛋白3(IGFBP-3)等数据。依据她们的年龄分别计算身高、骨龄、IGF-I以及IGFBP3的标准差积分(SDS)。结果 ICPP患儿GnRHa治疗1年后,按实际年龄的身高SDS从1.03±0.74下降至0.83±0.73(P<0.001),按骨龄的身高SDS从-0.56±0.78增至-0.26±0.65(P<0.001)。治疗前后IGF-I SDS,IGFBP-3SDS以及IGF-I/IGFBP-3差异无统计学意义(P>0.05)。与身高生长速度相关性最强的是提前的骨龄(R=0.291,P<0.05)。结论ICPP患儿GnRHa治疗前后IGF-I、IGFBP-3均无明显改变,GnRHa可能是通过抑制IGF-I分泌轴之外的机制来影响身高生长速度。Objective To recognize the effects and relationship between somatotropin axis function and growth velocity in girls with idiopathic central precocious puberty（ICPP）treated with gonadotropin-releasing hormone analogue（GnRHa）,and provide a theoretical basis for new treatments to cure growth deceleration after GnRHa therapy. Methods A total of27 girls with ICPP treated with GnRHa were studied prospectively.Their height,bone age（BA）,serum insulin-like growth factor-1（IGF-I）and IGF binding protein-3（IGFBP-3）concentrations at the beginning and the end of one year of GnRHa treatment were measured.The standard deviation scores（SDSs）of their height,BA,IGF-I,and IGFBP-3concentrations according to their age at the beginning and the end of one year of GnRHa treatment were calculated. Results After one-year GnRHa treatment,height SDS for CA（HtSDSCA）significantly decreased from 1.03±0.74 to 0.83±0.73（P〈0.001）,but height SDS for BA（HtSDSBA）increased from（-0.56±0.78）to（-0.26±0.65）（P〈0.001）.There was no significant change in serum IGF-I SDS,IGFBP-3SDS,and IGF-I/IGFBP-3ratio（P〉0.05）.The advanced BA was the factor most strongly correlated to the height velocity（R=0.291,P〈0.05）. Conclusions There is no significant change in serum IGF-I SDS,IGFBP-3SDS,and IGF-I/IGFBP-3ratio after GnRHa treatment.The height velocity affected by GnRHa treatment may due to other mechanism than suppression of the IGF-I secretory axis.

关 键 词：中枢性性早熟 促性腺激素释放激素类似物 促生长素轴 生长速度 

分 类 号：R179[医药卫生—妇幼卫生保健]