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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(Lu teinizing 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±0.21IU/L,差异有统计学意义;治疗1年后骨龄增速减缓,Δ骨龄/Δ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。
Objective To analyze the clinical efficacy of domestic controlled release of leuprolide acetate in the treatment of central precocious puberty. Methods Twenty patients with central precocious puberty were treated with homemade levophenanthroline for 12 months before and after treatment. The changes of the height and sexual characteristics, the changes of the genitalia (ovary), the changes of luteinizing hormone (LH) Peak change and bone age growth. Results The growth rate (GV) of 20 children decreased after treatment. Before treatment, they were (8.6 ± 1.6) cm / year, (7.15 ± 1.3) cm / 5.9 ± 1.1) cm / year and (5.2 ± 1.8) cm / year respectively. There was a statistically significant difference between the three groups. All the patients recovered significantly from 3 to 6 months after treatment, B-mode ultrasound showed that the ovary volume gradually decreased and the follicle size decreased Or disappear, treatment December ovarian volume <1ml, follicle <4mm or disappear. Gonadotropin-releasing hormone (GnRH) stimulation test LH, FSH peak before treatment was 21.24 ± 15.08 and 21.87 ± 7.22IU / L after 3 months of treatment was 1.73 ± 0.24 and 3.12 ± 0.21IU / L, the difference was statistically Significance; After 1 year of treatment, the growth of bone age slowed down, Δ bone age / Δ life age = 0.57, and the predicted height increased (3.8 ± 1.6) cm. CONCLUSION: Domestic sustained-release leuprolide acetate can inhibit sexual development and bone age in children with central precocious puberty and achieve the purpose of increasing the adult height of children with precocious puberty. Compared with imported drugs of the same kind, the same effect is obtained. Because of its relatively low prices, with greater economic value, the relatively poor economic conditions in the central region of precocious puberty in children is more applicable to the treatment.