小剂量司坦唑醇治疗生长迟缓患儿骨龄监测的意义

[目的]小剂量司坦唑醇治疗对生长迟缓患儿骨龄的影响及其与疗效的关系.[方法]对15例生长迟缓的患儿,其中部分性生长激素缺乏症10例,体质性生长发育延迟5例.年龄5～13(10.2±1.1)岁,男孩10例,女孩5例.所有患儿均予每日口服司坦唑醇0.02～0.04mg/kg,治疗时间4～16(8.9±4.5)个月,每隔3～6个月复查骨龄及身高,计算患儿生长速度(GV).[结果]15例患儿治疗前后生长速度由(3.95±0.22)cm/年提高到(7.60±2.15)cm/年,身高z评分(HtSDS)均有不同程度的提高,HtSDS由-2.50±0.58提高到-2.27±0.64(P<0.01),按骨龄的身高z评分由-1.04±0.97提高到-0.77±0.76(P<0.05).ΔHtSDSca0.24±0.26,ΔHtSDSba0.19±0.26,身高年龄增长值与骨龄增长值的比值(ΔHA/ΔBA)为1.23±0.47,其中2例ΔHA/ΔBA值小于1.ΔHtSDSca/ΔBA(岁)为0.27±0.24/岁,ΔHtSDSba/ΔBA(岁)为0.30±0.38/岁,其中2例比值为负数.[结论]小剂量司坦唑醇能改善未发育的部分性生长激素缺乏症与体质性生长发育延迟患儿的生长能力,同时骨龄成熟速度亦增加,因此,治疗过程必需密切观察骨龄变化.     

女性同性性早熟33例临床分析

目的　讨论女性性早熟的病因分类及真性性早熟的临床鉴别诊断。方法　女性同性性早熟患儿 33例 ,盆腔B超检查子宫和卵巢体积 ,做促性腺激素释放激素试验 ,取血测黄体生成素、促卵泡激素、雌二醇和睾酮。用达那唑口服治疗 10例特发性真性性早熟 (ICCP)患儿 ,对比治疗前后患儿的生长速度及骨龄变化。结果　 33例同性性早熟中 ,真性性早熟 17例 ,假性性早熟 16例。用达那唑治疗 10例ICCP ,生长速度 (6 .5± 1.4)cm/a增至(8.2± 1.5 )cm/a ,不伴骨龄增速。结论　鉴别真、假性性早熟 ,对指导治疗、判断预后意义重大。     

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.     

生长激素缺乏症治疗后骨龄的变化

目的研究原发性生长激素缺乏症(GHD)治疗24个月后身高年龄(HA)和骨龄的变化.方法17例GHD伴促性腺激素缺乏的男性患者,年龄14.8±2.27岁,HA8.16±1.5岁,给予重组人生长激素(rhGH,健高宁)治疗24个月,第13个月起合用绒毛膜促性腺激素或庚酸睾酮,观察疗效. 结果治疗第1年,生长速率(HV)11.25±1.89cm/年,身高年龄增加(△HA)2.13±0.36岁,骨龄增加(△BA)2.17±0.57岁,△HA/△BA1.06±0.36;第2年,HV13.39±2.52cm/年,△HA 2.18±0.59岁,△BA2.05±0.8岁,△HA/△BA1.13±0.29.患者治疗前、治疗后不同阶段的HA皆与BA呈正相关;两年身高标准差积分(HtSDS)增加2.55.结论单用rhGH和合用性激素治疗均对GHD患者有明显的促线性生长和发育作用,并且后者效果更佳;在促身高增加的同时也促骨龄成熟,而且两者平行.     

促性腺激素释放激素类似物治疗中枢性性早熟女性患儿的远期效果及不良反应

目的 探讨促性腺激素释放激素类似物（GnRHa）治疗中枢性性早熟（CPP）女性患儿的远期效果及不良反应。方法 回顾性分析64例接受GnRHa治疗的CPP女性患儿的治疗资料和随访资料。记录治疗期间的年生长速率、骨龄及骨龄的身高标准差分值(HtSDS_BA)、遗传靶身高、成年期终身高（FAH）、预测成人期终身高（PAH）、净获身高、超重/肥胖比例，以及随访终末时多囊卵巢综合征发生情况、月经情况等。结果 （1）随治疗时间延长，患儿的年生长速率整体呈下降趋势（P<0.05）,治疗后1年的年生长速率低于5 cm/年。（2）患儿的FAH为（160.98±4.95）cm,超过遗传靶身高，且高于治疗前和停药时的PAH（均P<0.05）;停药时的HtSDS_BA较治疗前增加（P<0.05）。64例患者中，92.2%（59/64）的患儿FAH超过遗传靶身高，93.8%（60/64）的患儿治疗后身高有所追赶；随访终末时，64例患儿的净获身高为（9.45±4.47）cm。（3）小年龄治疗组的净获身高高于大年龄治疗组（P<0.05）,但FAH差异无...     

曲普瑞林治疗特发性中枢性性早熟的疗效

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.     

GnRHa联合rhGH治疗儿童性早熟的效果分析

目的 观察探讨促性腺激素释放激素类似物(gonadotropin releasing hormone analogues,GnRHa)联合重组人生长激素(recombinant human growth hormone,rhGH)治疗儿童性早熟(precious puberty,PP)的效果。方法 方便选取2019年2月—2021年2月厦门大学附属第一医院收治的497例PP女性患儿为观察对象,按治疗方式不同分为GnRHa组(n=246)和GnRHa+rhGH组(n=251),GnRHa组给予GnRHa治疗,GnRHa+rhGH组在GnRHa组基础上联合rhGH治疗,比较两组患儿治疗后的生长发育指标[骨龄、实际身高(Ht)、预测成年身高(PAH)、年生长速度(GV)、身高标准差分值(HtSDS-BA)]、骨代谢指标[N端骨钙素(N-MID)、Ⅰ型胶原羧基端肽交联(β-CTX)、Ⅰ型原胶原氨基端肽(P1NP)]水平、性激素[促卵泡生成素(FSH)、雌二醇(E2)、促黄体生成素(LH)]水平及不良反应发生情况。结果 治疗后,GnRHa+rhGH组骨龄(11.24±0.59)岁、Ht(146....     

注射用醋酸曲普瑞林治疗儿童特发性性早熟60例效果分析

目的观察促性腺激素释放激素激动剂注射用醋酸曲普瑞林对于特发性中枢性早熟的临床治疗效果。方法选取60例特发性中枢性早熟女性患儿,给予每次80～100μg/kg的注射用醋酸曲普瑞林,每28d用1次,应用6～12个月,观察用药前后患者身高、第二性征、性激素的水平、骨龄变化并预测成年身高变化情况。结果 60例患儿于治疗后性激素LH、E2、FSH峰值下降,分别由之前的(22.0±8.4)IU/L(、15.9±7.6)IU/L和(31±12)pg/mL下,降为(2.8±1.7)IU/L(、1.7±1.5)IU/L和(11±8)pg/mL第,二性征减退;骨龄(BA)/实际年龄(CA)值由(1.33±0.19)下降为(1.18±0.13);成年后身高预测值由用药前的(156±5)cm升为治疗后的(160±6)cm,差异有统计学意义(P<0.05)。结论应用促性腺激素释放激素类似物注射用醋酸曲普瑞林治疗特发性早熟儿童,可明显抑制患者第二性征发育,降低性激素水平,延缓骨龄成熟,使得患者最终身高升高。     

长效促性腺激素类似物治疗女童特发性中枢性性早熟的疗效

目的观察长效促性腺激素类似物(GnRHa)治疗女童特发性中枢性性早熟(ICPP)的疗效和副作用.方法对36例ICPP女童进行GnRHa治疗,观察治疗前后第二性征、子宫容积、卵巢容积、卵泡发育、骨龄与年龄比值(BA/CA)、体块指数(BMI)和生长速率的变化,采用Greulich-Pyle法评价骨龄,用Payley-Pinneau法预测成年预测身高(PAH),ELISA法测定血清抑制素A(INHA)和抑制素B(INHB),用化学发光法测定血清LH和FSH.结果①治疗3～6个月乳房均有缩小,其中12例Tanner Ⅱ期的女童治疗6个月乳房恢复到B1期;②治疗6个月子宫容积[(3.28±2.20)ml vs (1.27±0.69)ml]和卵巢容积[(3.62±1.94)ml vs (1.24±0.50)ml]均缩小,卵泡缩小甚至消失;血清INHA和INHB由治疗前Log(0.93±0.35)ng/L、Log(1.95±0.37)ng/L下降到Log(0.60±0.32)ng/L、Log(1.46±0.32)ng/L.③治疗1年,BA/CA由治疗前1.40±0.20下降到1.26±0.15;PAH由(149.12±4.04)cm升高到(152.84±3.72)cm,BMI治疗前后无明显变化(16.04±1.68 vs 15.93±1.69).结论GnRHa治疗能有效抑制性腺轴及第二性征的发育,延缓骨龄的成熟,改善预测成人身高,短期应用未见明显副作用.     

促性腺激素释放激素类似物对特发性中枢性性早熟儿童最终成人身高的影响

目的 观察促性腺激素释放激素类似物(GnRHa)对特发性中枢性性早熟(ICPP)儿童最终成人身高的影响。方法30例ICPP女童用GnRHa治疗1年，进行前后自身对照，按骨龄预测成人期最终身高(PAH)。结果 治疗6个月、12个月后的预测PAH分别比治疗前增加平均2．5cm和3．9cm，治疗6个月与治疗前相比，以及治疗12月与治疗6个月相比，PAH均显著提高。未观察到近期的不良反应。结论 GnRHa能显著抑制ICPP患儿过早的性发育，延缓骨骺成熟，阻止骨骺过早融合，有益于改善最终身高。     

GnRHa治疗中枢性男性性早熟的疗效分析

目的观察促性腺激素释放激素类似物（GnRHa）对中枢性男性性早熟（CPP）男孩的第二性征、身高、骨龄、体重指数、预测身高等指标的影响。方法对28例中枢性男性性早熟男孩给予GnRHa治疗,辅以有氧运动,对治疗前后的第二性征、身高、骨龄、体重指数、预测身高、终身高等指标进行评价分析。结果治疗前身高（HT）（147．5±5．9）cm,预测身高（PAH）（164．8±5．4）cm,治疗1年后HT（154．3±6．0）cm,PAH（168．8±6．2）em,2年后HT（158．1±4．8）cm,PAH（172．2±6．5）cm;性激素水平（T、E2、LH、FSH）回至青春前期,睾丸有所缩小;骨龄受抑,骨龄的标准差分值（HtSDSBA）由原来的（-1．6±0．6）增至1年后的（-1．1±0．7）（P〈0．01）;2年后增至（-0．7±0．7）（P〈0．01）。结论GnRHa能有效改善中枢性男性性早熟的终身高,且无明显不良反应。     

ISOSEXUAL PRECOCIOUS PUBERTY CLINICAL ALALYSIS OF 109 PATIENTS

We treated 109 girls with isosexual precocious puberty with true precocious puberty in 63 and pseudoprecocious in 46. The true and pseudopreco- cious puberties were classified etiologically and dif- ferentiated according to their clinical features. Re suIts of treatment showed that chlormadinone was effective in controlling menstruation and secondary sex characters in 43 patients with true precocious puberty except 2 who were more than 8 years old, and that this agent has no effects on physical de- vdlopment including the final height.     

促性腺激素释放激素类似物治疗女童特发性中枢性性早熟的疗效分析

目的比较分析促性腺激素释放激素类似物(GnRHa)治疗女童特发性中枢性性早熟(ICPP)的临床疗效。方法 51例女童ICPP患儿用GnRHa治疗,疗程1～2年,观察治疗前后促黄体生成素峰值(P-LH)、促卵泡刺激素峰值(P-FSH)、雌二醇(E2)、子宫容积、卵巢容积以及随疗程变化体重指数(BMI)、骨龄(BA)、骨龄与生活年龄比值(BA/CA)、生长速率(GV)、预测成人身高(PAH)的动态变化。结果治疗前后促黄体生成素峰值、促卵泡刺激素峰值比较,差异有统计学意义(P<0.01);治疗前后骨龄与生活年龄比值、生长速率比较,差异有统计学意义(P<0.05);治疗前后预测成人身高有提高趋势,差异有统计学意义(P<0.05)。结论 GnRHa能有效抑制下丘脑-垂体-性腺轴治疗ICPP,但其促身高增长作用有待进一步研究。     

小剂量雌激素联合促性腺激素释放素类似物治疗儿童特发性中枢性性早熟

目的观察小剂量雌激素联合促性腺激素释放素类似物(GnRHa)治疗特发性中枢性性早熟(ICPP)的效果。方法 45例ICPP伴生长减速患儿分为3组:雌激素联合GnRHa治疗组、重组人生长激素(rhGH)联合GnRHa治疗组、单纯GnRHa治疗组,每组15例。分别于治疗前和治疗6个月后观察3组患儿骨龄(BA)、年生长速率(GV)、体质量、身高(Ht)、骨龄身高(Htba)、成年预测身高(PAH)、血脂、血糖、胰岛素、甲状腺功能、雌二醇(E2)、睾酮(T)、泌乳素(PRL)、血胰岛素样生长因子1(IGF-1)、乳房及子宫卵巢B超等的变化;另行GnRH激发试验监测促黄体生成素(LH)和促卵泡雌激素(FSH)水平。结果 3组患儿治疗前Ht、Htba、骨龄/年龄(BA/CA)、PAH、GV、体质量、IGF-1比较差别均无统计学意义(P>0.05)。治疗6个月后,雌激素联合GnRHa治疗组患儿GV、Ht、PAH明显高于治疗前(P<0.05),rhGH联合GnRHa治疗组患儿GV、Ht、PAH、IGF-1明显高于治疗前(P<0.05);且雌激素联合GnRHa治疗组和rhGH联合GnRHa治疗组患儿GV、Ht、PAH明显高于单纯GnRHa治疗组(P<0.05);rhGH联合GnRHa治疗组患儿IGF-1明显高于雌激素联合GnRHa治疗组和单纯GnRHa治疗组(P<0.05)。3组治疗前后E2、T、PRL、乳房及子宫和卵巢B超结果均无明显变化,GnRH激发试验LH、FSH和LH/FSH亦无明显变化(P>0.05)。结论小剂量雌激素联合GnRHa治疗ICPP,能在不加速BA的情况下有效地提高生长速率,且雌激素价格便宜,患者依从性好。     

Can Bone Age Determination Provide Criteria for Growth Hormone Treatment in Adopted Girls with Early Puberty?

In treatment of idiopathic central precocious puberty, GnRH analogues (GnRHa) have been accepted as the treatment of choice. Since growth velocity may be impaired with GnRHa treatment growth hormone (GH) treatment has been added in clinical trials. Recently, a study followed adopted girls with early or precocious puberty on GnRHa or combined GnRHa and GH treatment to final height. It was found that final height was significantly higher in the combined treatment group, although the difference was small. It was seen that patients that were extremely short at arrival and short at start of treatment seemed to be candidates for combined treatment.

We have now analysed the data in order to define criteria for the subgroup in need of combined GnRHa-GH treatment in order to achieve normal final height, i.e. above -2 SDS. Bone ages of 46 patients at start of treatment, randomized to either GnRHa treatment or GnRHa treatment combined with GH, were examined blindly by the same radiologist and the PAH calculated. The methods according to Greulich-Pyle / Bayley-Pinneau (GP/BP) and Tanner-Whitehouse (TW2) were used. Predictions versus final height data were analysed. The accuracy of FH prediction was greatest for GnRHa treated group using the GP/BP method. The GP/BP method gave useful cut off limits for when combined treatment was necessary to possibly achieve normal height. If pre-treatment GP/PAH was &gt; 157cm, the patients attained normal height with GnRHa treatment only. Ten out of 13 (77%) such girls could be correctly identified. Using TW2 with a cut off of 164 cm, 9 out of 13 could be selected. Using a multi regression equation of best fit the number of correctly selected cases for GnRHa treatment only, could not be further increased in this group.

We conclude that bone age determination and adult height prediction with the Greulich-Pyle/Bayley-Pinneau method, provides useful criteria for selecting the subgroup of adopted girls with early puberty where combined treatment with GnRHa and GH is not necessary to reach normal final height.     

Can bone age determination provide criteria for growth hormone treatment in adopted girls with early puberty?

In treatment of idiopathic central precocious puberty, GnRH analogues (GnRHa) have been accepted as the treatment of choice. Since growth velocity may be impaired with GnRHa treatment growth hormone (GH) treatment has been added in clinical trials. Recently, a study followed adopted girls with early or precocious puberty on GnRHa or combined GnRHa and GH treatment to final height. It was found that final height was significantly higher in the combined treatment group, although the difference was small. It was seen that patients that were extremely short at arrival and short at start of treatment seemed to be candidates for combined treatment. We have now analysed the data in order to define criteria for the sub-group in need of combined GnRHa-GH treatment in order to achieve normal final height, i.e. above -2 SDS. Bone ages of 46 patients at start of treatment, randomized to either GnRHa treatment or GnRHa treatment combined with GH, were examined blindly by the same radiologist and the PAH calculated. The methods according to Greulich-Pyle / Bayley-Pinneau (GP/BP) and Tanner-Whitehouse (TW2) were used. Predictions versus final height data were analysed. The accuracy of FH prediction was greatest for GnRHa treated group using the GP/BP method. The GP/BP method gave useful cut off limits for when combined treatment was necessary to possibly achieve normal height. If pre-treatment GP/PAH was > 157cm, the patients attained normal height with GnRHa treatment only. Ten out of 13 (77%) such girls could be correctly identified. Using TW2 with a cut off of 164 cm, 9 out of 13 could be selected. Using a multi regression equation of best fit the number of correctly selected cases for GnRHa treatment only, could not be further increased in this group. We conclude that bone age determination and adult height prediction with the Greulich-Pyle/Bayley-Pinneau method, provides useful criteria for selecting the subgroup of adopted girls with early puberty where combined treatment with GnRHa and GH is not necessary to reach normal final height.     

276例中枢性性早熟女童性激素基础值与激发值关系的分析

目的：研究中枢性性早熟女童性激素基础值与激发值的关系。方法整群选取该院内分泌科2014年9月-2015年12月收治的276例中枢性性早熟女童为研究对象,进行促性腺激素释放激素类似物(GnRHa)激发试验,比较所有患儿激发前后的血清促卵泡激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)浓度浓度情况。结果Ⅱ期患者GnRHa激发后FSH、LH、E2的峰值分别为(9.48±2.84)IU/L、(18.11±12.61)IU/L、(43.13±25.02)pg/mL显著高于Ⅱ期GnRHa激发前FSH、LH、E2的基础值(3.26±1.49)IU/L、(0.71±0.64)IU/L、(26.45±17.24)pg/mL。结论中枢性性早熟女童性激素基础值与激发值的关系,促性了腺激素释放激素类似物激发试验作为诊断性早熟的检查方法,具有良好的临床应用价值。     

Efficacy of Subcutaneous Administration of Gonadotropin-releasing Hormone Agonist on Idiopathic Central Precocious Puberty

In order to assess the feasibility of subcutaneous administration of Triptorelin with 6-week intervals for the suppression of pituitary-gonadal axis and changes of clinical signs in girls with idiopathic central precocious puberty (ICPP), 46 girls with ICPP were treated with GnRHa. Triptorelin (Decapeptyl, 3.75 mg) was administered subcutaneously (SC) at 6-weeks intervals or intramuscularly (IM) at 4-weeks intervals randomly for more than 12 months consecutively. During GnRHa therapy, clinical parameters and laboratory data, including height, weight, pubertal stage, bone age, uterine volume and ovarian size, serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2), were monitored and analyzed. It was found that both treatment regimes led to regression of precocious puberty and reversal of secondary sexual characteristics. Breast developments regressed. Uterine volume was decreased after treatment, but there was no statistically significant difference. Mean ovarian volume did not change significantly during treatment. The height velocity was decreased significantly from 6.3±1.4 cm/year to 5.8±1.2 cm/year in group SC and 6.7±1.3 cm/year to 5.4±1.0 cm/year in group IM, respectively. The rate of bone maturation was reduced significantly during treatment. The ratio of deltaBA/deltaCA was 1.2±0.2 or 1.3±0.3 at the onset of therapy and decreased significantly after the treatment to 0.7±0.2 or 0.9±0.1, respectively. The predicted adult height was increased significantly and progressively during therapy. The levels of serum LH, FSH and E2 returned to the prepubertal condition. No significant side effects of therapy were noted. The most common side effect during SC treatment was that a non-irritating, 1 cm in diameter mass was palpated at the site of subcutaneous injection in the abdominal wall of patients, which disappeared after 6-12 weeks. Two girls had minimal withdrawal vaginal bleeding episodes after the first injection. It was concluded that both IM and SC triptorelin administrations were clinically effective. They induce profound suppression of hypothalamic-pituitary-gonadal axis while stabilizing height velocity, slowing bone maturation and increasing predicted adult height. These results suggest that subcutaneous injection of triptorelin in 6-weeks intervals at a dosage of 3.75 mg be a safe and acceptable regimen for ICPP     

促性腺激素释放激素拟似剂对青春期大鼠生长轴与性腺轴相关基因表达的影响

目的 探讨促性腺激素释放激素拟似剂(GnRHa)对青春期大鼠生长轴与性腺轴的影响及其作用机制。方法 青春期大鼠应用GnRHa后，取其下丘脑、垂体、卵巢、下肢骺软骨等组织，应用荧光定量PCR(FQ-PCR)技术检测组织中相应激素的基因表达水平。结果 GnRHa可使下丘脑中促性腺激素释放激素(GnRH)和垂体中GnRH受体(GnRHR)基因表达水平下降，下丘脑中生长激素释放抑制激素(SRIH)基因表达水平增高，生长激素释放激素(GHRH)基因表达无变化；垂体中生长激素(GH)、卵巢中雌激素受体(ER)、下肢骺软骨中胰岛素样生长因子—1(IGF-1)等基因表达水平均下降。结论GnRHa除抑制垂体GnRHR产生受体降调节外，还可抑制下丘脑GnRH的基因表达，使性腺激素水平降低，从而减缓第二性征的成熟程度和速度；同时GnRHa通过促进下丘脑SRIH的基因表达，抑制垂体GH和下肢骺软骨IGF-1的基因表达。这可能是Gn—RHa延缓特发性真性性早熟患儿骨骺闭合的机理之一。