Objective To explore the clinical effect of gonadotropin - releasing hormone analogue( GnRHa)on idiopathic central precocious puberty(ICPP)in girls and its influence on the hormone level of hypothalamic - pituitary - gonadal (HPG)axis. Methods 81 girls with ICPP who accorded with the inclusion and exclusion criteria from the Department of Children's Growth and Development of Lishui People's Hospital in Zhejiang Province from January 2004 to October 2013 were collected in the study. Based on health education,the subjects were given acetic acid triptorelin treatment. Recombinant human growth hormone therapy was added when a subject's growth decelerated. The indicators of growth and development(height,body mass,BA,ΔBA/ ΔCA,PAH,GⅤ)were observed and calculated before the treatment and in month 3,month 6,month 12 and month 24 during the treatment. The secondary sex characteristics,hormone level( E2 ,LH,FSH)of the subjects were observed before treatment and in month 6 during the treatment,and the adverse events were also recorded. Results There were 19 subjects who were given recombinant human growth hormone therapy. And there were 18 subjects who discontinued treatment 12 months after treatment began, for their BA became corresponded to their age or their parents saw their PAH reached expectation. Therefore,a total of 63 subjects were included,with a losing rate of 22. 2%. The subjects had different height,body mass,BA,ΔBA/ ΔCA,PAH,GⅤ at different time points(P < 0. 05). With the treatment continued,the subjects saw their height,body mass,BA and PAH increased and their ΔBA/ ΔCA and GⅤ decreased(P < 0. 05). In month 6 during treatment, the secondary sexual characteristics of the subjects were evidently inhibited,6 subjects stopped menstruation,and 48 subjects had their breasts receding to Tanner 2 or Tanner 1 from Tanner 3. In month 6 during treatment,the serum E2 level,FSH,LH base value and peak value of the subjects were lower than those before treatment(P < 0. 05). During treatment,apart from a case of slight skin symptom,no other adverse events occurred. Conclusion For girls with ICPP,GnRHa can effectively control their forward growth and development,reduce sex hormone level,postpone the appearance of secondary sexual characteristics, and increase adult height. Recombinant human growth hormone therapy can be jointly used with GnRHa when growth decelerates, which is highly effective and safe. This may be due to the dual control of HPG axis and dynamic equilibrium.%目的：探讨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）女童的临床疗效及其对下丘脑-垂体-性腺轴（HPG 轴）激素水平的影响。方法选取2004年1月—2013年10月浙江省丽水市人民医院儿童生长发育科符合纳入与排除标准的 ICPP 患儿81例为研究对象。在健康教育的基础上，均给予醋酸曲普瑞林治疗，出现生长减速时联合重组人生长激素粉针剂治疗。观察或计算患儿治疗前及治疗3、6、12、24个月时的生长发育指标〔身高、体质量、骨龄（ BA）、骨龄差值/年龄差值（ΔBA/ΔCA）、预测成年期终身高（ PAH）和生长速率（GⅤ）〕，观察治疗前及治疗6个月时患儿第二性征与激素〔血清雌二醇（ E2）、黄体生成素（ LH）、促卵泡生成素（FSH）〕水平，记录不良反应。结果治疗过程中，19例患儿同时接受重组人生长激素粉针剂治疗。治疗12个月后18例患儿因 BA 与年龄相仿或 PAH 达到患儿家长的预期而停止治疗，最终共纳入63例患儿，删失率为22.2％。不同时间患儿的身高、体质量、BA、ΔBA/ΔCA、PAH、GⅤ比较，差异有统计学意义（ P ＜0.05）。随着治疗时间的延长，患儿的身高、体质量、BA、PAH 逐渐增加，ΔBA/ΔCA、GⅤ逐渐减小，差异有统计学意义（ P ＜0.05）。治疗6个月后，患儿第二性征明显抑制，其中6例患儿月经撤退，48例患儿乳房从 Tanner 3期退缩到 Tanner 2期或 Tanner 1期。治疗6个月患儿血清 E2水平、FSH、LH 基值、峰值均较治疗前降低（P ＜0.05）。治疗过程中，除1例患儿出现轻微皮肤症状外，未见其他明显的不良反应。结论对 ICPP 女童给予 GnRHa 治疗能够有效控制患儿前移的生长发育，降低性激素水平，推迟第二性征的出现，增加 PAH，生长减速时可联合应用重组人生长激素治疗，具有较好的临床疗效和较高的安全性，这可能与 HPG 轴的双重调控、动态平衡有关。
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