曲普瑞林治疗中枢性性早熟女童的疗效及安全性研究

Study on Efficacy and Safety of Triptorelin in the Treatment of Central Precocious Puberty in Girls

关键词:  曲普瑞林  中枢性性早熟  疗效  安全性

Key words:  triptorelin  central precocious puberty  efficacy  safety

摘要:

目的 探究曲普瑞林治疗中枢性性早熟女童的疗效及安全性。方法 以2020年1月—2022年8月海宁市人民医院儿童生长发育专科门诊诊治的49例中枢性性早熟女童为研究对象，经曲普瑞林规范治疗及规律随访>1年，分析比较治疗前、治疗6个月后、治疗12个月后的疗效及安全性。结果 治疗6个月后与治疗12个月后相比，子宫、卵巢容积无明显变化，但均较治疗前缩小，乳房Tanner分期治疗后有缩小，简易激发提示性激素促黄体生成素值较治疗前下降，身体质量指数逐渐升高，骨龄/实际年龄逐渐下降，各组间差异均有统计学意义(P<0.05)。治疗最初3个月生长速率最高，部分患儿后续生长速率渐下降，治疗后有3例出现少量阴道出血。此外，对于联用生长激素，家长较大顾虑为药物不良反应。结论 曲普瑞林治疗中枢性性早熟女童可有效抑制性腺轴及性腺发育，延缓骨龄进展，治疗中除部分患儿出现生长速率下降和少量阴道出血外，其他不良反应少。

Abstract:

OBJECTIVE To explore the efficacy and safety of triptorelin in the treatment of central precocious puberty in girls. METHODS A total of 49 girls with central precocious puberty who were treated at Haining People's Hospital's pediatric endocrinology clinic from January 2020 to August 2022 were included in this study. These patients were treated with triptorelin according to standardized protocols and followed up for at least one year. The therapeutic efficacy and safety were analyzed and compared before treatment, after 6 months of treatment, and after 12 months of treatment. RESULTS After 6 and 12 months of treatment, there were no significant changes in uterine and ovarian volume, but both showed a reduction compared to before treatment. The Tanner stage of breast development decreased after treatment, and the luteinzing hormone levels measured by a simple stimulation test decreased compared to before treatment. Body mass index gradually increased, while bone age/chronology age ratio gradually decreased. These differences between the time points were statistically significant(P<0.05). The growth rate was highest in the first 3 months of treatment, and then gradually decreased in some patients. Three cases experienced minor vaginal bleeding after treatment. Additionally, parents expressed concerns about the use of growth hormone due to drug adverse reactions. CONCLUSION Triptorelin effectively suppresses the hypothalamic- pituitary-gonadal axis and delays skeletal maturation in girls with central precocious puberty. Apart from some cases of decreased growth rate and minor vaginal bleeding, adverse reactions are minimal during treatment.