长效促性腺激素释放激素类似物和甲孕酮治疗对真性性早熟女孩预测身高影响的比较

目的观察促性腺激素释放激素类似物（ＧｎＲＨａ）和甲孕酮用于治疗真性性早熟女孩，对其抑制性发育，减慢骨成熟和生长速度，改善成人期预测身高的作用。方法分别使用两种药物治疗两组特发性真性性早熟女孩各９例，时间６～１２个月，观察治疗前后的身高、性发育情况、骨龄、成人期预测身高等，并进行综合比较。结果两组患儿经治疗后，性发育情况大多数得到抑制。甲孕酮治疗组骨龄年增长为１１岁，身高年增长为７６ｃｍ，成人期预测身高治疗前后无改变。长效ＧｎＲＨａ组骨龄年增长为０２岁，身高年增长为５６ｃｍ，成人期预测身高治疗６个月时增长３１ｃｍ，较治疗前明显改善（Ｐ＜００１），治疗１年时增长６４ｃｍ，较治疗６个月时更为明显（Ｐ＜００５）。结论长效ＧｎＲＨａ与甲孕酮相比较，除可抑制性发育进程外，还可有效减慢骨成熟和生长速度，最终改善成人期预测身高，治疗时间愈长，效果愈明显

The comparison of the effect of long-acting gonadotropin-releasing hormone analogue and provera therapy on predicted height in girls with true precocious puberty

Objective To observe the value of long-acting gonadotropin-releasing hormone analogue(GnRHa) and porvera therapy on suppress sex development,slowing the rates of bone maturation and growth,improve the adult predicted height in girls with true precocious puberty.Methods We compared girls with true precocious puberty treated with GnRHa and provera,analyzed the growth sex development and adult predicted height of two groups of girls.Results The sex development of 2 groups of girls with true precocious puberty was suppressed.The provera-treated girls have a mean bone age increment of 1.1 year per year,and mean height increment of 7.6cm per year.The mean adult predicted height has not changed after treated.The GnRHa-treated girls have a mean bone age increment of 0.2 year per year,and mean height increment of 5.6cm per year.The mean adult predicted height of GnRHa-treated girls has increased 3.1cm in six months,significantly greater than the height before therapy( P <0.01),has increased 6.4cm in one year,significantly greater than that in six months. Conclusion Comparing provera,long-acting GnRHa thrapy in girls with true precocious puberty not only suppress sex development,but also slowing bone maturation and growth,increasing adult predicted height.The treated time is longer,the effect is more significant.