CAJ | 학술논문

目的观察促性腺激素释放激素类似物(GnRHa)对较大年龄特发性真性性早熟女孩身高改善的作用.方法对49例大于8岁的性早熟女孩采用GnRHa治疗,每3～6个月评价生长参数的变化以判断疗效,分析预测成年身高的相关因素.结果预测成年身高在治疗6个月时为(157.7±4.5)cm,12个月时为(159.2±4.4)cm,结束时为(160.8±5.0)cm,与开始时预测成年身高(155.5±5.1)cm相比差异有统计学意义(P＜0.01),结束时的预测成年身高高于遗传身高(157.6±3.4)cm(P＜0.05).按骨龄的身高标准差分值(HtSDS-BA)从治疗6个月后开始增加,分别为(-0.64±0.68、-0.52±0.70、-0.36±0.68),与开始时(-0.94±0.68)相比差异有统计学意义(P＜0.01);按生活年龄的身高标准差分值(HtSDS-CA)在治疗前后差异无统计学意义.生长速率出现减慢,治疗结束时为(4.8±1.5)cm/年,明显低于治疗前(6.3±1.3)cm/年(P＜0.01).预测成年身高与治疗开始年龄、发病年龄无相关(P＞0.05),与骨龄负相关,与HtSDS-CA、HtSDS-BA、生长速度、身高、遗传靶身高、疗程等呈正相关(P＜0.01).结论 GnRHa能有效改善较大年龄特发性真性性早熟女孩的预测成年身高.治疗开始和结束时的身高的标准差分值、遗传身高、生长速率是影响预测成年身高的主要因素.
목적 관찰촉성선격소석방격소유사물(GnRHa)대교대년령특발성진성성조숙녀해신고개선적작용.방법 대49례대우8세적성조숙녀해채용GnRHa치료,매3～6개월평개생장삼수적변화이판단료효,분석예측성년신고적상관인소.결과 예측성년신고재치료6개월시위(157.7±4.5)cm,12개월시위(159.2±4.4)cm,결속시위(160.8±5.0)cm,여개시시예측성년신고(155.5±5.1)cm상비차이유통계학의의(P＜0.01),결속시적예측성년신고고우유전신고(157.6±3.4)cm(P＜0.05).안골령적신고표준차분치(HtSDS-BA)종치료6개월후개시증가,분별위(-0.64±0.68、-0.52±0.70、-0.36±0.68),여개시시(-0.94±0.68)상비차이유통계학의의(P＜0.01);안생활년령적신고표준차분치(HtSDS-CA)재치료전후차이무통계학의의.생장속솔출현감만,치료결속시위(4.8±1.5)cm/년,명현저우치료전(6.3±1.3)cm/년(P＜0.01).예측성년신고여치료개시년령、발병년령무상관(P＞0.05),여골령부상관,여HtSDS-CA、HtSDS-BA、생장속도、신고、유전파신고、료정등정정상관(P＜0.01).결론 GnRHa능유효개선교대년령특발성진성성조숙녀해적예측성년신고.치료개시화결속시적신고적표준차분치、유전신고、생장속솔시영향예측성년신고적주요인소.
Objective The purpose of this study was to evaluate effects of gonadotropin-releasing hormone analogs (GnRHa) on improvement of predicted adult height (PAH) in girls with idiopathic central precocious puberty (ICPP) initiating treatment at age of eight years or over and analyze its related factors.Methods Forty-nine girls with ICPP aged eight years and over were treated with GnRHa for ( 17.4 ±5.6) months initiating at age of (9.3 ± 0.6) years during 2005 and 2008.They were followed-up every three to six months to evaluate its effects on growth velocity (GV), height standard deviation score for chronological age (HtSDS-CA), height SDS for bone age (HtSDS-BA), PAH, and so on, as well as their related factors.Results PAH increased after GnRHa treatment, from ( 157.7 ± 4.5) cm six months after treatment to ( 159.2 ±4.4) cm 12 months after treatment, and to ( 160.8 ±5.0) cm by the end of treatment from ( 155.5 ±5.1 ) cm at its initiation (P ＜0.01 ).There was significant difference in PAH by the end of treatment and target height (TH) [( 157.6 ±3.4) cm].HtSDS-BA increased since six months after GnRHa treatment, from ( -0.64 ±0.68) six months to ( -0.52 ±0.70) 12 months after it and ( -0.36 ±0.68)by the its end, all significantly different from ( - 0.94 ± 0.68 ) that at the initiation of treatment ( P ＜0.01 ).There was no significant difference in HtSDS-CA before and after treatment.GV decreased from the initiation (6.3 ± 1.3) cm/yr to (4.8 ± 1.5) cm/yr by the end of treatment ( P ＜ 0.01 ).No significant association between PAH and age of the initiation of treatment and between PAH and age by the end of treatment were found (P ＞ 0.05 ).But, PAH reversely correlated with bone age, and positively correlated with HtSDS-CA, HtSDS-BA, GV, TH and length of treatment ( P ＜ 0.01 ).Conclusions GnRHa can remarkably improves PAH in girl with ICPP.PAH mainly correlates with HtSDS-BA, TH and GV at the initiation and the end of treatment.