醋酸曲普瑞林联合膳食干预对特发性中枢性性早熟女童代谢及卵巢功能的影响

Effects of dietary intervention with treprostinil acetate on metabolism and ovarian function in girls with idiopathic central precocious puberty

摘要:

目的 探讨醋酸曲普瑞林联合膳食干预对特发性中枢性性早熟女童代谢及卵巢功能的影响。方法 前瞻性选取2018年1月—2022年1月安徽省儿童医院100例特发性中枢性性早熟女童，采用随机数字表法分为对照组和研究组，每组50例。对照组采用膳食干预，研究组在对照组基础上联合醋酸曲普瑞林治疗，治疗周期均持续6个月。观察两组的临床疗效，比较两组治疗前、治疗6个月时的生长发育指标（身高、体重、预测成年终身高、体质量指数、骨龄）、代谢指标［骨密度值、维生素D、N端骨钙素（N-MID）、I型胶原羧基端肽β特殊序列（β-CTx）、Ⅰ型前胶原氨基端延长肽（PⅠNP）］、卵巢功能［孕酮（P）、睾酮（T）、雌二醇（E₂）、催乳素（PRL）、促黄体生成素（LH）、促卵泡生成激素（FSH）］，并统计两组不良反应发生情况。结果 两组治疗前、治疗6个月各生长发育指标差值比较，差异有统计学意义（P <0.05），与对照组相比，研究组身高、预测成年终身高更高，体重更轻，骨龄更小；两组治疗前、治疗6个月各代谢指标差值比较，差异有统计学意义（P <0.05），两组骨密度值、维生素D水平高于治疗前，N-MID、β-CTx、PⅠNP水平低于治疗前，且研究组治疗前后各指标差值大于对照组；两组治疗前、治疗6个月各卵巢功能指标差值比较，差异有统计学意义（P <0.05），两组P、T、E₂、PRL、LH、FSH水平低于治疗前，且研究组治疗前后各指标差值大于对照组。治疗期间，两组均未发生明显不良反应。结论 醋酸曲普瑞林联合膳食干预对特发性中枢性性早熟女童具有良好的治疗效果，能够改善患儿的生长发育状况，降低代谢水平，提升卵巢功能，且无明显不良反应。

Abstract:

Objective To investigate the effects of combining dietary intervention with treprostinil acetate on metabolism and ovarian function in girls with idiopathic central precocious puberty.Methods From January 2018 to January 2022, 100 girls with idiopathic central precocious puberty were prospectively selected and randomly divided into control group (50 cases) and research group (50 cases). The control group was treated with dietary intervention, and the research group was treated with triptorelin acetate on the basis of the control group. The treatment period lasted for 6 months. The clinical efficacy of the two groups, including the growth and development indexes of the two groups before and after treatment for 6 months (height, weight, predicted adult lifetime height, body mass index, bone age), metabolic indicators [bone mineral density values, vitamin D, N-terminal osteocalcin (N-MID,) type I collagen carboxy-terminal peptide β special sequence (β-CTx), type I precollagen amino-terminal extension peptide (PⅠNP)], ovarian function [progesterone (P), testosterone (T), estradiol (E₂), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH)], and the incidence of adverse reactions in the two groups was observed and compared.Results After 6 months of treatment, compared with the control group, the study group has higher clinical efficacy, higher height and predicted adult life height, larger difference between height and predicted year-end height before and after treatment, lighter weight, younger bone age and smaller difference between weight and bone age before and after treatment (P < 0.05). The bone mineral density and vitamin D levels in the two groups were higher than those before treatment, while the levels of N-MID, β-CTx, PⅠNP, P, T, E₂, PRL, LH, and FSH were lower than those before treatment, and the difference of each index in the study group before and after treatment is greater than that in the control group (P < 0.05). During the treatment, no obvious adverse reactions occurred in the two groups.Conclusion Treprostinil acetate combined with dietary intervention has good therapeutic effects on girls with idiopathic central precocious puberty, improving growth and development, lowering metabolic levels, and enhancing ovarian function with fewer adverse effects.