不同剂量促性腺激素释放素激动剂治疗儿童性早熟的疗效对比研究  

Effects of different doses of gonadotropin releasing hormone agonists on bone metabolism and hormone levels in children with idiopathic central precocious puberty

作　　者：赵庆贺[1] 刘俊 徐豪杰 ZHAO Qinghe;LIU Jun;XU HaoJie(Department of Pharmacy,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第三附属医院药学部,河南郑州450052

出　　处：《世界临床药物》2021年第6期473-477,500,共6页World Clinical Drug

摘　　要：目的探讨不同剂量促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRHa)醋酸曲普瑞林对特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)患儿的影响。方法收集我院自2016年5月至2019年5月收治的ICPP患儿100例,并将其随机分为高剂量组和低剂量组,每组50例。高剂量组和低剂量组的患儿分别给予醋酸曲普瑞林80 μg/kg和60 μg/kg治疗,评价不同剂量醋酸曲普瑞林对ICPP患儿的生长发育(身高、体质量、肥胖率、超重率、体质量指数和骨龄)、骨代谢(Ⅰ型原胶原氨基端肽和Ⅰ型胶原羧基端肽交联)、性激素(促黄体生成素、促卵泡生成素和雌二醇)和不良反应的影响。结果治疗前与治疗12周后,两组患儿身高、体质量、体质量指数、肥胖率、超重率、Ⅰ型原胶原氨基端肽、Ⅰ型胶原羧基端肽交联、促黄体生成素、促卵泡生成素和雌二醇差异均无统计学意义(P>0.05);高剂量组患儿的骨龄明显高于低剂量组(P<0.05),此外高剂量组肌痛发生率明显高于低剂量组(12.00% vs 0.00%,P=0.035)。结论低剂量的醋酸曲普瑞林治疗可明显改善患儿的生长发育、骨代谢及激素的水平,且不良反应发生率较低,可作为临床上推荐治疗方案,具有一定的临床价值。Objective To investigate the effects of different doses of gonadotropin-releasing hormone agonists(GnRHa) triptorelin acetate on children with idiopathic central precocious puberty(ICPP).Methods A total of 100 children with ICPP admitted to our hospital from May 2016 to May 2019 were enrolled and randomly divided into high-dose group and low-dose group,with 50 cases in each group.Patients in the high-dose group were treated with high-dose triptorelin acetate(80 μg/kg),and patients in the low-dose group were given low-dose triptorelin acetate(60 μg/kg).Then the growth and development(height,weight,obesity rate,overweight rate,body mass index,and bone age),bone metabolism(type Ⅰ procollagen amino terminal peptide and type Ⅰ collagen carboxy terminal peptide cross-linking),hormones(luteinizing hormone,follicle stimulating hormone and estradiol) and adverse reactions of children with ICPP were objectively evaluated with different doses of triptorelin acetate.Results There was no significant difference in height,weight,body mass index,obesity rate,overweight rate,type Ⅰ procollagen amino terminal peptide,type Ⅰ collagen carboxy terminal peptide cross-linking,luteinizing hormone,follicle stimulating hormone and estradiol between the two groups before and after treatment(P>0.05).The bone age in high-dose group was significantly higher than that in low-dose group(P<0.05).The incidence of myalgia in high dose group was significantly higher than that in low dose group(12.00% vs 0.00%,P=0.035).Conclusion Low-dose triptorelin acetate treatment can significantly improve the growth and development of children,bone metabolism and hormone levels,and the incidence of adverse reactions is low.It can be used as a clinically used dose and has certain clinical value.

关 键 词：促性腺激素释放激素激动剂 醋酸曲普瑞林 剂量 特发性中枢性性早熟 生长发育 

分 类 号：R459.1[医药卫生—治疗学]