GnRHa对性早熟女童下丘脑-垂体-性腺轴的调控作用  

Regulation effect of GnRHa on hypothalamic pituitary gonadal axis in girls with idiopathic central precocious puberty

作　　者：吴丽敏[1] 蔡大芬[2] 张海燕[1] 孙金娥[2] WU Limin;CAI Dafen;ZHANG Haiyan;SUN Jin＇e(Department of Pediatrics,Xiaogan Central Hospital,Xiaogan 432000,Hubei,China;Department of Obstetrics and Gynecology,Xiaogan Central Hospital,Xiaogan 432000,Hubei,China)

机构地区：[1]孝感市中心医院儿科,湖北孝感432000 [2]孝感市中心医院妇产科,湖北孝感432000

出　　处：《中国性科学》2018年第7期101-104,共4页Chinese Journal of Human Sexuality

基　　金：湖北省卫生厅青年人才基金科研项目课题(QJX2010-60)

摘　　要：目的:探讨促性腺激素释放激素类似物(GnRHa)对特发性中枢性性早熟(ICPP)女童下丘脑-垂体-性腺轴(HPG轴)的调控作用。方法:选取2014年4月至2015年4月孝感市中心医院收治的符合纳入及排除标准的性早熟女童患儿84例,随机分为参照组与研究组(各42例),参照组给予西医药物常规处理,研究组给予GnRHa进行治疗,观察并分析两组患儿治疗前与治疗24个月时血清雌二醇(E_2)、促卵泡生成素(FSH)、黄体生成素(LH)的分泌水平、第二性征的变化以及临床疗效,并记录其不良反应。结果:治疗24个月时两组ICPP患儿的血清E_2、LH和FSH分泌水平的基值与峰值均分别明显低于治疗前,差异具有统计学意义(P<0.05),且治疗24个月时研究组的E_2、LH和FSH分泌水平的基值与峰值明显低于参照组,差异具有统计学意义(P<0.05)。治疗24个月时,参照组与研究组患儿的第二性征均被明显抑制,研究组患儿的月经撤退、乳房变小以及乳房TannerⅠ期均明显高于参照组,差异具有统计学意义(P<0.05),且研究组的总有效率为88.10%,显著大于参照组,差异具有统计学意义(P<0.05)。治疗过程中,研究组不良反应发生率为4.76%,明显小于参照组,差异具有统计学意义(P<0.05)。结论:GnRHa可通过抑制HPG轴而降低性激素(E_2、LH、FSH)的分泌水平,能够有效调节生长发育,抑制第二性征,对ICPP女童患儿有较好的临床治疗效果,且不良反应较小。Objective： To investigate the regulation effect of gonadotropin releasing hormone analogue （GnRHa） on hypothalamic pituitary gonadal axis （HPG axis） in girls with idiopathic central precocious puberty （ICPP）. Methods： 84 girls who met the criteria of inclusion and exclusion were selected from April 2014 to April 2015 and they were randomlydivided into control group and study group,42 cases in each group. The control group was given routine treatment of western medicine,and the study group was given GnRHa for treatment. The serum secretion levels of serumestradiol （E_2）,follicle stimulating hormone （FSH）,luteinizing hormone （LH） levels,the changes of secondary sex characteristics and the clinical effect of two groups were observed and analyzed before treatment and 24 months after treatment,and the adverse reactions were recorded. Results： The basal and peak levels of serum E_2,LH and FSH secretions were significantly decreased in the two groups after 24 months of treatment compared with those before treatment （P〈 0. 05）,and the basal and peak levels of serum E_2,LH and FSH secretions in study group were significantly lower than those of control group （P〈 0. 05）. After 24 months of treatment,secondary sex characteristics were significantly suppressed in both control group and study group,and the menstrual retreat,small breast and breast TannerⅠstage of the children in the study group were significantly higher than those in control group （P〈 0. 05）. The total effective rate in study group was 88. 10%,which was significantly higher than that of control group （P〈 0. 05）. In the course of treatment,the incidence of side effects of study group was 4. 76%,which was significantly smaller than that in the control group （P〈 0. 05）. Conclusions： GnRHa can reduce the hormones （E2,LH,FSH） levels by inhibiting HPG axis,which can effectively regulate the growth and inhibit development of secondary sexual characteristics,with better clinical curative effect on gi

关 键 词：促性腺激素释放激素类似物 性早熟 下丘脑-垂体-性腺轴 调控作用 

分 类 号：R725.8[医药卫生—儿科]