摘要
目的：观察特发性中枢性性早熟（ICPP）女童使用促性腺激素释放激素类似物（GnRHa）治疗前后性腺轴的变化，并观察其对糖代谢的影响。方法46例ICPP患儿用GnRHa治疗，疗程12个月，观察治疗前后子宫容积、卵巢容积、成熟卵泡数量、促性腺激素释放激素（ GnRH）激发试验激素水平、骨龄（ BA）、骨龄与生活年龄比值（ BA／CA）、预测成年身高（ PAH）的变化及空腹血糖、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数（ HOMA－IR）、体质指数（ BMI）的变化。结果治疗后3个月子宫容积、卵巢容积较治疗前明显缩小，成熟卵泡数量减少，差异有统计学意义（F＝36．157、14．314、27．085，均P＜0．01）；治疗后3个月与治疗后6个月、治疗后6个月与治疗后1年比较，差异均无统计学意义（均P＞0．05）。 LH、FSH峰值、E2、BA、BA／CA、PAH等指标的治疗前、治疗后6个月及治疗后1年的总体比较显示，上述指标差异均有统计学意义（ F＝23．907、22．485、14．584、96．503、13．364、14．661，均P＜0．01）。 BA／CA在治疗后6个月与治疗前差异无统计学意义（P＝0．101），治疗后1年与治疗前差异有统计学意义（F＝13．364，P＜0．05）。 LH、FSH峰值、E2、BA和PAH在治疗后6个月与治疗前差异有统计学意义（P＜0．05）。对治疗后6个月与治疗后1年的结果比较显示，LH和BA，两者差异有统计学意义（P＜0．01），而FSH、E2和PAH差异无统计学意义（P＞0．05）。治疗后6个月、1年后空腹血糖、餐后2 h血糖、空腹胰岛素、HOMA－IR、BMI与治疗前比较，差异均无统计意义（均P＞0．05）。结论 GnRHa治疗ICPP能有效抑制中枢性性早熟，持续用药可延缓骨龄成熟，改善患儿成年身高，且对患儿的糖代谢无影响。
Objective To observe the effect and its influence of blood glucose metabolism about treatment with gonadotropin -releasing hormone analog （ GnRHa ） in girls with idiopathic central precocious puberty （ CPP ） . Methods Fourty-six girls with ICPP were treated for 12 months.Uterine volume,ovarian volume,mature follicle number,GnRH,hormone levels of GnRH stimulation test ,BA,BA/CA,PAH,fasting glucose,2 -hour postprandial glucose,fasting insulin were measured and compared before and after the GnRHa treatment .Results （1） After 3months treatment,Uterine volume,ovarian volume and the mature follicle number were significantly decreased （F=36.157,14.314 and 27.085,all P〈0.01）.There was no difference between 3 months after treatment and 6 months after treatment,6 months after treatment and 1 year after treatment（P〉0.05）.（2）The overall comparison about LH, FSH Peak,E2 ,BA,BA/CA,PAH and other indicators before treatment ,after 6 months treatment and after 1 year treat-ment showed these indicators were significantly different （ F=23.907,22.485,14.584,96.503,13.364 and 14.661, all P〈0.01）.BA/CA was no significant different（P=0.101） before and after 6 months treatment,but was significantly different（F=13.364,P〈0.05） before and after 1 year treatment.LH,FSH peak,E2,BA and PAH before and after 6 months treatment were significantly different（P〈0.05） before and after 6 months treatment.The results about LH and BA were very significant different （ P〈0.01） after treatment for 6 months and for 1 year,but FSH,E2 and PAH had no difference（P〉0.05）.（3）Fasting blood glucose after 6 months and 1 year treatment,fasting insulin,HOMA-IR,BMI 2-hour after meal were not statistically significant （P〉0.05）.Conclusion GnRHa treatment of ICPP could effectively inhibit the central precocious puberty , continuous medication could delay bone agemature and improveadult height of patient children, and had no effect on glucose metabolism of patient children.
出处
《中国基层医药》
CAS
2015年第5期653-656,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
性早熟
特发性中枢性
促性腺激素释放激素类似物
糖代谢
Precocious puberty,idiopathic central
Gonadotropin -releasing hormone analog
Glucose metabolis
