女性真性性早熟药物治疗疗效分析  

Effect of different drug therapy in central precocious puberty girls

作　　者：项如莲[1] 留佩宁[1] 王秀娣[1] 游欢庆[1] 李迎春[1] 吴丽慧[1] 

机构地区：[1]温州医学院附属育英儿童医院,浙江温州325000

出　　处：《实用儿科临床杂志》2004年第4期252-254,共3页Journal of Applied Clinical Pediatrics

基　　金：温州市科委课题资助项目 (KW 980 0 1 3)

摘　　要：目的　评价亮丙瑞林、达那唑、酮康唑、醋酸甲羟孕酮治疗女性真性性早熟的疗效。方法　女性性早熟 6 1例分别用酮康唑 4～ 8mg/ (kg·d) ,达那唑 5～ 10mg/ (kg·d) ,亮丙瑞林 30～ 90 μg/kg ,醋酸甲羟孕酮 8～10mg/d治疗。观察治疗前后患儿第二性征、骨龄、血清性激素变化。 结果　亮丙瑞林组治疗后第二性征减退 ,血激发试验峰黄体生成素 (LH)、卵泡刺激素 (FSH)及基础FSH、血清胰岛素样生长因子 1(IGF 1)显著下降 (P均 <0 .0 5 ) ,骨龄增长减慢 ;达那唑组第二性征减退 ,但血指标改变不大 ,个别病例有丙氨酸氨基转移酶 (ALT)改变等副作用 ;酮康唑对第二性征和激素变化均不明显 ;醋酸甲羟孕酮组除乳房略回缩外其他性征及激素无变化 ,且阴道出血率高。结论　亮丙瑞林治疗女性真性性早熟除可使第二性征逆转外 ,还可使激素下降、骨龄生长延缓 ;而达那唑、酮康唑、醋酸甲羟孕酮仅能改变第二性征 ,不能改变其他指标 ,且副作用大 。Objective To analyse the effect induced by leuprorelin,danazlo,ketoconazole,medroxyprogesteron acetate in central precocious puberty (CPP) girls.Methods Sixty-one CPP girls were observed.Twenty-four patients were treated by leuprorelin [30-90 μg/(kg·m)],and comparable to danazol[12 patients,5-10 mg/(kg·d)],ketoconazole [12 patients,4-8 mg/(kg·d)] or medroxyprogesteron(13 patients, 8-10 mg/d). The sexual sign,bone age,serum hormone were compared before and during treatment.Results The second sexual sign descend and serum peak luteinizing hormone,follicle-stimulating hormone(FSH) and base FSH,insulin-like growth factor-1 declined during treatment by leuprorelin;although the second sexual sign descend in danazol groups,the serum maker was of no change and the serum alanine aminotransferase was step up in individual cases.Ketoconazole was not of obvious changes in sexual sign and serum hormone;medroxyprogesteron acetate can make breasts become smaller,but it also can lead to high bleeding rate of uterine.Conclusions Leuprorelin can make not only sexual sign change but also serum hormone and bone age decrease;but danazlo,ketoconazole and medroxy progesterm acetate are only effective to sexual sign and can't make other factors change.Otherwise there are of great side effects.Therefore leuprorelin is considered as a better drug of treating central precocious puberthy.

关 键 词：性早熟 亮丙瑞林 达那唑 酮康唑 醋酸甲羟孕酮 

分 类 号：R725.8[医药卫生—儿科]