醋酸亮丙瑞林辅助维生素D在特发性性早熟患儿中的应用效果  

Effect of leuprorelin acetate combined with vitamin D in children with idiopathic central precocious puberty

作　　者：董瑾[1] 张瑄[1] 黄乐[1] Dong Jin;Zhang Xuan;Huang Le(Department of General Internal Medicine,Tianjin Children's Hospital(Tianjin University Children's Hospital),Tianjin 300134,China)

机构地区：[1]天津市儿童医院(天津大学儿童医院)综合内科,天津300134

出　　处：《中国现代医学杂志》2025年第6期60-64,共5页China Journal of Modern Medicine

基　　金：天津市医学重点学科(专科)建设项目(No:TJYXZDXK-040A)。

摘　　要：目的探讨醋酸亮丙瑞林辅助维生素D在特发性性早熟(ICPP)患儿中的应用效果。方法选取2021年1月—2023年12月在天津市儿童医院收治的100例ICPP患儿。采用分层随机抽样法将患儿分为试验组和对照组,各50例。对照组接受醋酸亮丙瑞林治疗,试验组接受醋酸亮丙瑞林联合维生素D治疗。对比两组生长状况、卵巢容积、卵泡直径、子宫容积、性激素(E_(2)、FSH、LH)、血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平、不良反应(局部疼痛、轻度过敏、红斑、炎症、阴道出血)的差异。结果试验组治疗前后身高、生长速度和成年身高的差值均高于对照组(P<0.05)。两组治疗前后体质量指数、骨龄的差值比较,差异均无统计学意义(P>0.05)。试验组治疗前后卵巢容积、卵泡直径、子宫容积的差值均大于对照组(P<0.05)。试验组治疗前后E_(2)、FSH、LH的差值均高于对照组(P<0.05)。试验组治疗前后IGF-1的差值高于对照组(P<0.05),IGFBP-3的差值低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论醋酸亮丙瑞林辅助维生素D治疗ICPP患儿效果显著,能有效促进生长发育,控制性激素水平,提高IGF-1、IGFBP-3水平,且不良反应风险较低。Objective To evaluate the effect of leuprorelin acetate combined with vitamin D in the treatment of idiopathic central precocious puberty.Methods This study was conducted from January 2021 to December 2023,involving 100 children with idiopathic central precocious puberty admitted to Tianjin Children's Hospital.Using stratified random sampling,patients were divided into an experimental group and a control group,with 50 cases in each group.The control group received leuprolide acetate treatment,while the experimental group was treated with leuprolide acetate combined with vitamin D.The growth status,ovarian volume,follicle diameter,uterine volume,levels of sex hormones[estradiol(E_(2)),follicle-stimulating hormone(FSH),luteinizing hormone(LH)],serum insulinlike growth factor-1(IGF-1),and insulin-like growth factor-binding protein-3(IGFBP-3),and adverse reactions(local pain,mild allergy,erythema,inflammation,vaginal bleeding)were compared between the two groups.Results In the experimental group,the differences in height,growth velocity,and predicted adult height before and after treatment were all greater than those in the control group(P<0.05).The differences in body mass index and bone age before and after treatment between the experimental and control groups showed no statistical significance(P>0.05).The differences in ovarian volume,follicle diameter,uterine volume,and levels of E_(2),FSH,LH,and IGF-1 before and after treatment were all greater in the experimental group compared to the control group(P<0.05).The difference in the level of IGFBP-3 before and after treatment was lower in the experimental group than in the control group(P<0.05).The overall incidence of adverse reactions between the two groups showed no significant difference(P>0.05).Conclusions Leuprolide acetate combined with vitamin D significantly enhances growth and development,controls hormone levels,increases IGF-1 and IGFBP-3 levels,and presents a lower risk of adverse reactions in children with idiopathic central precocious puberty.

关 键 词：特发性性早熟 醋酸亮丙瑞林 维生素D 生长发育 血清胰岛素样生长因子-1 胰岛素样生长因子结合蛋白-3 

分 类 号：R725.8[医药卫生—儿科]