CAJ | 학술논문

目的：评价国产促性腺激素释放激素类似物（GnRHa）治疗特发性中枢性性早熟（ICPP）女孩的疗效及安全性。方法：入组35例ICPP女孩，年龄（8.17±2.01）岁，治疗采用国产注射用亮丙瑞林缓释微球。观察治疗6个月后患儿身高、第二性征变化、骨龄增长情况、体重指数，以及子宫卵巢变化、卵泡刺激素、黄体生成素、雌二醇变化，分析年龄、骨龄的身高标准差分值（HtSDSCA，HtSDSBA），评价治疗效果及治疗过程中出现的不良反应。结果：35例患儿经GnRHa治疗6个月骨龄显著受抑，预测成年身高增高；血清卵泡刺激素、黄体生成素、雌激素水平降低至青春前期水平；乳房回缩，4例月经初潮患者在治疗后月经暂停来潮。用药过程中未观察到明显不良反应，用药后患者体重指数无明显变化。结论：国产GnRHa能有效抑制性征发育和骨龄增长，能减少ICPP女孩骨龄-年龄间差距而改善预测成年身高，且更经济实用，适合临床推广。
목적：평개국산촉성선격소석방격소유사물（GnRHa）치료특발성중추성성조숙（ICPP）녀해적료효급안전성。방법：입조35례ICPP녀해，년령（8.17±2.01）세，치료채용국산주사용량병서림완석미구。관찰치료6개월후환인신고、제이성정변화、골령증장정황、체중지수，이급자궁란소변화、란포자격소、황체생성소、자이순변화，분석년령、골령적신고표준차분치（HtSDSCA，HtSDSBA），평개치료효과급치료과정중출현적불량반응。결과：35례환인경GnRHa치료6개월골령현저수억，예측성년신고증고；혈청란포자격소、황체생성소、자격소수평강저지청춘전기수평；유방회축，4례월경초조환자재치료후월경잠정래조。용약과정중미관찰도명현불량반응，용약후환자체중지수무명현변화。결론：국산GnRHa능유효억제성정발육화골령증장，능감소ICPP녀해골령-년령간차거이개선예측성년신고，차경경제실용，괄합림상추엄。
To evaluate the efficacy and safety of domestic gonadotropin releasing hormone analogue (GnRHa) in the treatment of girls with idiopathic central precocious puberty (ICPP). Methods:Thirty-ifve ICPP girls (average age 8.17±2.01 years) who received the therapy of delayed release leuprorelin acetate microspheres for injection were enrolled. The changes of body height, secondary sex characters, bone age, body mass index, uterus and ovaries, and the serum level of FSH, LH and E2 were observed after 6 months of GnRHa treatment. Height standard deviation scores (SDS) for both chronological age (HtSDSCA) and bone age (HtSDSBA) were analyzed. Adverse reactions during treatment were evaluated. Results:Bone ages of 35 ICCP girls were signiifcantly suppressed after 6 months of treatment. HtSDSCA, HtSDSBA and predict adult heights (PAH) were increased. The serum level of FSH, LH and E2 decreased to the prepubertal level. Breasts sizes were signiifcantly reduced and 4 cases with menarche represented amenorrhea. No signiifcant adverse reactions were observed during the treatment and the body mass index of the patients had no signiifcant changes. Conclusion:Domestic GnRHa therapy can effectively suppress the development of sex characters, reduce the bone age-chronologic age advancement and improve the PAH of girls with ICPP. Therefore, it is more economical and practical for clinical practice and worthy of clinical use.