GnRHa对特发性中枢性性早熟女童内分泌代谢、骨代谢及脂代谢的影响  

Effect of GnRHa on endocrine metabolism,bone metabolism and lipid metabolism in girls with idiopathic central precocious puberty

作　　者：曹玲 亢相逢 常蕊[3] CAO Ling;KANG Xiangfeng;CHANG Rui(Department of Neonatal,Yulin First Hospital,Yulin 719000,Shaanxi,China;Department of Pediatrics,Yulin First Hospital,Yulin 719000,Shaanxi,China;Department of Obstetrics and Gynecology,Yulin First Hospital,Yulin 719000,Shaanxi,China)

机构地区：[1]榆林市第一医院新生儿科,陕西榆林719000 [2]榆林市第一医院儿科,陕西榆林719000 [3]榆林市第一医院妇产科,陕西榆林719000

出　　处：《中国性科学》2018年第10期151-155,共5页Chinese Journal of Human Sexuality

基　　金：陕西省科技计划社会发展攻关项目(2015LL07-2-517)

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)女童内分泌代谢、骨代谢和脂代谢的影响。方法:将2014年9月至2017年1月榆林市第一医院收治的ICPP女童50例设为研究组,给予GnRHa治疗;将同期入院健康女童50例设为对照组。记录治疗前后两组女童预测成年身高(PAH)、体质指数(BMI)、骨龄(BA)、骨龄身高标准差分值(Ht SDBA),测定其促卵泡生成激素(FSH)和促黄体生成素(LH)、雌二醇(E2)、Ⅰ型胶原氨基端前肽(PⅠNP)、β-胶原降解产物(β-CTX)、骨钙素氮端中分子片段(N-MID)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,记录不良反应。结果:治疗后,研究组女童PAH(151. 25±16. 41) cm、BMI(17. 65±1. 78) kg/m^2、BA(10. 67±1. 12)岁比治疗前升高(P <0. 05),Ht SDBA(1. 90±0. 21) cm比治疗前降低,且与对照组女童比较差异无统计学意义(P> 0. 05);治疗后,研究组女童FSH(2. 02±0. 26) IU/L、LH(2. 84±0. 38) IU/L、E2(10. 77±1. 17)ng/L均低于治疗前,且与对照组比较差异无统计学意义(P> 0. 05)。治疗前,研究组女童PⅠNP、N-MID均高于对照组(均P <0. 05),两组女童β-CTX比较差异无统计学意义(P> 0. 05)。治疗后,研究组女童PⅠNP(743. 10±75. 99) ng/ml、N-MID(14. 55±1. 81) ng/ml均比治疗前明显下降(均P <0. 05)。治疗前后,两组女童HDL-C、HDL-C、LDL-C比较,其差异均无统计学意义(均P> 0. 05)。研究组50例女童服药后出现头痛1例、皮肤瘙痒2例,均在停药后缓解,可以耐受。结论:GnRHa可以有效调节ICPP女童内分泌代谢、骨代谢,对脂代谢无明显影响,且不良反应轻微,值得在临床中推广应用。Objective： To investigate the effect of gonadotropin releasing hormone analogue（ GnRHa） on endocrine metabolism,bone metabolism and lipid metabolism in girls with idiopathic central precocious puberty（ ICPP）. Methods： A total of 50 girls with ICPP who were admitted to Yulin First Hospital during September 2014 to January 2017 were treated with GnRHa. Another 50 healthy girls were selected as the control group. The predicted adult height（ PAH）,body mass index（ BMI）,bone age（ BA） and standard deviation of bone age and height（ HtSD_（BA）） of the two groups were recorded before and after treatment. The levels of follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2）,type I collagen amino-terminal propeptide（ P I NP）,β collagen degradation products（ β-CTX）,osteocalcin N-terminal middle molecule fragment（ N-MID）,triglyceride（ TG）,high-density lipoprotein protein cholesterol（ HDL-C） and low-density lipoprotein cholesterol（ LDL-C） were determined. Adverse reactions were recorded. Results： After treatment,PAH,BMI and BA of study group were longer,higher and older than those before treatment（ P〈0. 05）,Ht SD_（BA） was shorter than that before treatment,and compared with the control group,there was no significant difference（ P〉0. 05）. After treatment,levels of FSH,LH and E_2 in study group were lower than those before treatment,without statistically significant differences between the two groups（ P〉0. 05）. Before the treatment,P I NP and N-MID in study group were higher than thosein the control group（ P〈0. 05）,while there was no significant difference between two groups in β-CTX（ P〉0. 05）. After treatment,levels of P I NP and N-MID in study group were significantly lower than those before treatment（ P〈0. 05）. There was no significant difference in HDL-C,HDL-C and LDL-C between the two groups before and after treatment（ P〉0. 05）. There was a girl with headache and 2 girls with pruritus after

关 键 词：GNRHA 特发性中枢性性早熟 女童 内分泌代谢 骨代谢 脂代谢 

分 类 号：R725.8[医药卫生—儿科]