Abstract:

Objective　To investigate the efficacy of leuprolide combined with growth hormone in girls with idiopathic central precocious puberty (ICPP), in order to guide the development of clinical therapeutic interventions for the clinical benefit of ICPP girls. Methods　Using the random number table method, 80 girls with ICPP admitted to Putian Maternal and Child Health Care Hospital from January 2021 to December 2022 were divided into two groups, with 40 cases in each group. The age of the observation group was (8.05±1.47) years old; the course of disease was (13.67±3.10) months; the height was (137.62±2.73) cm; the Tanner stage was stage II in 19 cases, stage III in 17 cases, and stage IV in 4 cases. The age of the control group was (8.11±1.35) years old; the course of disease was (13.96±3.87) months; the height was (137.06±2.96) cm; the Tanner stage was stage II in 18 cases, stage III in 19 cases, and stage IV in 3 cases. The control group was injected subcutaneously with leuprorelin, with the first dose of 3.75 mg, and then 120 μg/kg each time, once every 4 weeks, for 6 months. Based on this, the observation group was subcutaneously injected with growth hormone 30 min before going to bed, 0.15 IU/kg each time, once a day, for 6 months. The treatment effect, uterine/ovarian volume, and levels of sex hormones were compared between the two groups, and the incidence of adverse reactions during treatment was statistically analyzed. t test, χ² test, and rank sum test were used. Results　The total effective rate of the observation group was 97.50% (39/40), which was higher than that of the control group [80.00% (32/40)] (P<0.05). The volumes of uterus and ovary were decreased in both groups after treatment, and those in the observation group were smaller compared to the control group (all P<0.05). The levels of estradiol (E₂), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were decreased in both groups after treatment, and those in the observation group were lower compared to the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group [12.50% (5/40) vs. 7.50% (3/40)] (P>0.05). Conclusion　The efficacy of leuprolide combined with growth hormone in ICPP girls is satisfactory, which can adjust the levels of sex hormones and reduce the volumes of uterus and ovary, with good safety.

Key words:

Idiopathic central precocious puberty, Girls, Leuprolide, Growth hormone, Ovarian volume, Sex hormones, Adverse reactions

摘要：

目的　探讨特发性中枢性性早熟（ICPP）女童使用亮丙瑞林联合生长激素治疗的效果，以指导临床治疗措施的拟定，使ICPP女童临床获益。方法　使用随机数字表法将2021年1月至2022年12月莆田市妇幼保健院收治的ICPP女童80例分为两组，各40例。观察组年龄（8.05±1.47）岁；病程（13.67±3.10）个月；身高（137.62±2.73）cm；Tanner分期：Ⅱ期19例，Ⅲ期17例，Ⅳ期4例。对照组年龄（8.11±1.35）岁；病程（13.96±3.87）个月；身高（137.06±2.96）cm；Tanner分期：Ⅱ期18例，Ⅲ期19例，Ⅳ期3例。对照组皮下注射亮丙瑞林，首次剂量3.75 mg，后每次120 μg/kg，4周注射一次，连续治疗6个月。基于此，观察组加用生长激素，于睡前30 min皮下注射，0.15 IU/kg，1次/d，连续治疗6个月。比较两组治疗效果、子宫/卵巢容积、性激素水平，统计两组治疗期间不良反应发生情况。采用t检验、χ²检验、秩和检验。结果　与对照组治疗总有效率80.00%（32/40）相比，观察组治疗总有效率97.50%（39/40）较高（P<0.05）；治疗后两组子宫、卵巢容积均缩小，且观察组比对照组小（均P<0.05）；治疗后两组雌二醇（E₂）、促卵泡激素（FSH）及黄体生成素（LH）水平均降低，且观察组比对照组低（均P<0.05）；观察组不良反应发生率12.50%（5/40）与对照组7.50%（3/40）比较，差异无统计学意义（P>0.05）。结论　ICPP女童使用亮丙瑞林联合生长激素治疗效果满意，可调节性激素水平，缩小子宫、卵巢容积，且安全性好。

关键词:

特发性中枢性性早熟, 女童, 亮丙瑞林, 生长激素, 卵巢容积, 性激素, 不良反应