目的 观察曲普瑞林治疗特发性中枢性性早熟的临床疗效.方法 对200例特发性中枢性性早熟患儿均采用曲普瑞林治疗,初治剂量100 μg·kg-1,自第4个月起减量至60～80 μg·kg-1,每4 周注射1次,治疗12～36(21.10±7.43)个月.观察200例患儿治疗前,治疗后6、12、24、36个月的骨龄(BA)、生长速率(GV)及身高(PAH)的变化等情况.结果 治疗后BA的增长低于年龄的增长.年龄为(9.31±1.13)、(9.89±1.06)、(10.41±1.13)、(11.02±1.21)岁的患儿:治疗前BA为(10.63±1.05)岁,治疗后6、12、24、36个月BA分别为(11.01±0.98)、(11.42±1.01)、(11.75±1.12)、(11.98±1.07)岁,二者比较差异均有统计学意义(均P＜0.01);治疗前△BA/△CA比值为1.73±0.25,治疗后6、12、24、36个月△BA/△CA比值分别为0.86±0.39、0.61±0.28、0.48±0.32、0.22±0.26,二者比较差异均有统计学意义(均P＜0.01);治疗前 GV 为(8.50±1.43) cm·a-1,治疗后6、12、24、36个月GV分别为(6.70±1.26)、(6.40±1.25)、(5.30±1.38)、(4.50±1.32)cm·a-1,二者比较差异均有统计学意义(均P＜0.01);治疗前PAH为(151.26±4.63)cm,治疗后6、12、24、36个月PAH分别为(152.29±3.91)、(153.13±4.33)、(154.58±5.09)、(156.31±5.34)cm,二者比较差异均有统计学意义(均P＜0.01).结论 曲普瑞林能有效地抑制特发性中枢性性早熟的性征发育和骨龄的增长,改善成年身高.%Objective To observe the curative effect of triptorelin on idiopathic central precocious puberty.Methods Two hundred children with idiopathic central precocious puberty were treated with triptorelin once every 4 weeks for (21.10±7.43) months (range 12 to 36 months).After initial treatment with triptorelin (100 μg · kg-l) for 3 months,the children were injected with a decreased dose of triptorelin (60-80μg · kg-1).The bone age(BA),growth rate(GV), predicted adult height(PAH) were observed before and 6,12,24,36 months after treatment.Results After treatment, the increase in BA was less than that in age.In children aged (9.31 ± l.13), (9.89±1.06), (10.41±1.13) and (11.02±1.21)years,BA before treatment [(10.63± 1.05) years old]was significantly lower than that 6, 12, 24 and 36 months after treatment [(11.01±0.98) ,(11.42±1.01), (11.75± 1.12) and (11.98±1.07) years old,respectively;all P＜0.01].△BA/△CA ratio before treatment (1.73 ±0.25) was significantly higher than that 6, 12,24 and 36 months after treatment (0.86±0.39,0.610.28,0.48±0.32 and 0.22±0.26,respectively;all P＜0.01).GV before treatment (8.50±1.43)cm · a-1 was obviously higher than that 6,12,24 and 36 months after treatment [(6.70± 1.26), (6.40 ± 1.25), (5.30± 1.38) and (4.50±1.32) cm · a-1 ,respectively;all P＜0.01].PAH before treatment [(151.26±4.63)cm]was obviously lower than that 6, 12, 24 and 36 months after treatment [(152.29± 3.91), (153.13±4.33) ,(154.58±5.09) and (156.31±5.34)cm,respectively;all P＜0.01)].Conclusion Triptorelin can effectively inhibit the development of sexual characteristics and the increase in bone age and improve adult height in children with idiopathic central precocious puberty.
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