国产注射用缓释醋酸亮丙瑞林治疗中枢性性早熟疗效观察

目的 分析国产注射用缓释醋酸亮丙瑞林治疗中枢性性早熟的临床疗效.方法 分析20例中枢性性早熟的女性患儿经国产注射用缓释醋酸亮丙瑞林治疗12月前后的身高、性征变化、内生殖器(卵巢)变化、黄体生成素(Luteinizing Hormone,LH)峰值变化及骨龄增长情况.结果 20例患儿治疗后生长速率(GV)均有下降,治疗前、治疗后3月、6月、12月分别为(8.6±1.6)cm/年、(7.15±1.3)cm/年、(5.9±1.1)cm/年、(5.2 ±1.8)cm/年,各组间差异有统计学意义；所有患儿治疗后3～6月乳房明显回缩,B超提示卵巢体积逐渐缩小,卵泡缩小或消失,治疗12月卵巢体积均＜1ml,卵泡＜4mm或消失.促性腺激素释放激素(GnRH)激发试验LH、促卵泡素(FSH)峰值治疗前为21.24±15.08和21.87±7.22IU/L,治疗3月后为1.73 ±0.24和3.12±0.2 1IU/L,差异有统计学意义；治疗1年后骨龄增速减缓,△骨龄/△生活年龄=0.57,预测身高增加(3.8±1.6)cm.结论 国产注射用缓释醋酸亮丙瑞林能抑制中枢性性早熟患儿性征发育及骨龄进展,达到增加性早熟患儿成年身高的目的,与同类进口药品相比,具有同样的效果.因其价格相对低,具有较大的经济学价值,对经济条件相对差的西部地区中枢性性早熟患儿的治疗更为适用.

Curative effect of domestic sustained release leuprorelin acetate microspheres on children with central precocious puberty

Objective To analyze the clinical curative effect of domestic sustained release leuprorelin acetate micro- spheres on central precocious puberty. Methods The difference of height, sex character, internal genitalia （ovary）, LH peak value as well as bone age between initial state and cured state among 20 female children were determined before and after treat- ment with domestic sustained release leuprorelin acetate microspheres. Results The growth rate of children with central pre- cocious puberty was reduced. The growth rate before treatment was （8.6±1.6） cm/year and the growth rate were （7.15± 1.3） crrd year, （5.9± 1.1） cm/year, （5.2 ±1.8） cm/year 3, 6 and 12 month after treatment,showing statistical/y significan differences.After treatment, the breast size of the precocious puberty children was reduced or even become normal. The type-B ultrasonic shows the size of their ovary was decreased and the ovarian follicle was minified or even disappeared. After 12 months＇ treatment, their ovary was smaller than 1m1 or disappeared and the ovarian follicle was smaller than 4mm or disappeared. In the GnRH provocative test, the peak values of LH, FSH before treatment were （21.24± 15.08） and （21.87±7.22）IU/L. The value changed to （1.73 ±0. 24） and （3.12±0.21）IU/L 3 months after treatment, showing statistical significance. The growth rate of patients＇ bone age was reduced（Δbone agc/Δape=0.57） a year after treatment and the forecasted height increased by （3.8± 1.6）era. Conclusion Domestic leuprorelin acetate microspheres could restrain the sexual character development and bone age growth rate of central precocious puberty patients and achieve the objective of increase the height. Thus it is suitable for clinical use on central pre- cocious puberty patients in the relative poor regions in west China.