曲普瑞林联合生长激素对女童中枢性性早熟骨代谢的影响  

Effects of triptorelin combined with growth hormones on bone metabolism in girls with central precocious puberty

作　　者：彭锦英 甘明月 李飞燕 黄金花 胡海玲 PENG Jinying;GAN Mingyue;LI Feiyan;HUANG Jinhua;HU Hailing(Children’s Medical Center,Affiliated Hospital of Guangdong Medical University,Guangdong Zhanjiang 524002,China)

机构地区：[1]广东医科大学附属医院儿童医学中心,广东湛江524002

出　　处：《中国医院药学杂志》2025年第7期804-808,共5页Chinese Journal of Hospital Pharmacy

基　　金：湛江市非资助科技攻关计划项目(编号:2021B1442);广东医科大学立项资助科研项目(编号:GDMUM2020051)。

摘　　要：目的:探究曲普瑞林联合生长激素治疗对女童中枢性性早熟患儿骨代谢的影响。方法:选取2020年8月至2022年5月入院治疗的女童中枢性性早熟108例,按照随机数字表法分为两组,各54例。对照组用曲普瑞林治疗,治疗组在对照组基础上联合生长激素治疗。治疗1年后,比较两组患儿性激素、性腺发育、卵巢功能、生长情况及骨代谢水平。结果:治疗组治疗后卵巢、子宫体积小于对照组,抗苗勒试管激素(anti-Muller hormone,AMH)和抑制素B(inhibin B,INHB)水平低于对照组(P<0.05)。治疗组治疗后预测成年终身高(predictive adult height,PAH)和年平均生长速度(average growth rate,ΔGV)高于对照组,骨龄差值(bone age difference,ΔBV)低于对照组(P<0.05)。治疗组治疗后Ⅰ型前胶原氨基端肽(N-terminal prepeptide of type Ⅰ procollagen,P1NP)和骨钙素N端中分子片段(N-terminal mid-fragment of osteocalcin,N-MID)水平高于对照组(P<0.05),但2组β-胶原降解产物(β-C-terminal telopeptide of type I collagen,β-CTX)的比较,差异无统计学意义(P>0.05)。2组不良反应发生率的比较(18.52%vs.11.11%),差异无统计学意义(P>0.05)。结论:对于女童中枢性性早熟患儿,应用曲普瑞林联合生长激素治疗可有效降低性激素水平,改善卵巢功能和骨代谢水平,从而提高生长速率。OBJECTIVE To explore the effects of triptorelin combined with growth hormones on bone metabolism in girls with central precocious puberty.METHODS A total of 108 girls with central precocious puberty admitted between August 2020 and May 2022 were enrolled.According to random number table method,they were randomly divided into the control group(54 cases,triptorelin)and treatment group(54 cases,triptorelin+growth hormones).After 1 year of treatment,sex hormones,gonad development,ovarian function,growth status and bone metabolism level in the two groups were compared.RESULTS After treatment,girls with central precocious puberty in the treatment group had significantly smaller ovarian volume and uterine volume,and lower anti-Muller hormone(AMH)and inhibin B(INHB)levels than those of the control group(P<0.05).After treatment,girls with central precocious puberty in the treatment group had significantly higher predictive adult height(PAH)and average annual growth rate(ΔGV),but lower bone age difference(ΔBV)than those of the control group(P<0.05).After treatment,levels of N-terminal prepeptide of type Ⅰ procollagen(P1NP)and N-terminal mid-fragment of osteocalcin(N-MID)were significantly higher in the treatment group than those of the control group(P<0.05),but there was no significant difference in theβ-C-terminal telopeptide of type Ⅰcollagen(β-CTX)between the two groups(P>0.05).There was no significant difference in the incidence of adverse events between the two groups(18.52%vs.11.11%,P>0.05).CONCLUSION Triptorelin combined with growth hormones can effectively reduce levels of sex hormones,improve ovarian function and bone metabolism levels,and thus accelerate the growth rate in girls with central precocious puberty.

关 键 词：中枢性性早熟 曲普瑞林 生长激素 卵巢功能 骨代谢 

分 类 号：R963[医药卫生—微生物与生化药学] R725.8[医药卫生—药理学]