Wang Lan, Jiang Qun, Wang Manman, Xu Jiawang, Jin Juhua
Department of Pediatrics, Xiaoshan Hospital Affiliated to Hangzhou Normal University, Hangzhou, China.
Department of Pediatrics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Transl Pediatr. 2021 Sep;10(9):2307-2312. doi: 10.21037/tp-21-352.
This study aimed to explore the effects of triptorelin and leuprolide on serum hormone levels and the clinical efficacy of girls with idiopathic central precocious puberty (ICPP).
Retrospective analysis was performed on 128 girls with ICPP who were diagnosed and treated in our hospital from January 2017 to January 2020, including 71 girls in the leuprolide group and 57 girls in the triptorelin group. The differences of serum sex hormone level, ovarian volume, uterine volume, follicle diameter, bone age, growth rate (height change within half a year), maturity (bone age/living age), and other aspects between the two groups of girls were compared.
Before treatment, there was no significant difference in the baseline levels of sex hormones [estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH)] between the triptorelin group and the leuprorelin group (P>0.05). After 1 year of treatment, serum levels of E2 and FSH in the triptorelin group were lower than those in the leuprolide group (P<0.05). There was no significant difference in LH levels between the two groups after 1 year of treatment (P>0.05). At baseline, there was no significant difference in the ovarian volume, follicle diameter, and uterine volume between the triptorelin group and the leuprolide group (P>0.05). After 1 year of treatment, the ovarian volume, follicle diameter, and uterine volume of the girls in the triptorelin group were all lower than those in the leuprolide group (P<0.05). Before treatment, there was no statistical difference in bone age, growth rate, and maturity between the triptorelin group and the leuprolide group (P>0.05). After 1 year of treatment, the growth rate and maturity of participants in the triptorelin group were lower than those in the leuprolide group (P<0.05). There was no significant difference in bone age between the two groups after 1 year of treatment (P>0.05).
For girls with ICPP, triptorelin is superior to leuprolide in reducing sex hormone level, reducing uterine volume, follicle diameter, ovarian volume, slowing down the growth rate, and decreasing maturity. Triptorelin should be selected as a priority for the treatment of girls with ICPP.
本研究旨在探讨曲普瑞林和亮丙瑞林对特发性中枢性性早熟(ICPP)女童血清激素水平的影响及临床疗效。
对2017年1月至2020年1月在我院诊断并治疗的128例ICPP女童进行回顾性分析,其中亮丙瑞林组71例,曲普瑞林组57例。比较两组女童血清性激素水平、卵巢体积、子宫体积、卵泡直径、骨龄、生长速率(半年内身高变化)、成熟度(骨龄/实际年龄)等方面的差异。
治疗前,曲普瑞林组与亮丙瑞林组性激素[雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)]基线水平比较,差异无统计学意义(P>0.05)。治疗1年后,曲普瑞林组血清E2和FSH水平低于亮丙瑞林组(P<0.05)。治疗1年后两组LH水平比较,差异无统计学意义(P>0.05)。基线时,曲普瑞林组与亮丙瑞林组卵巢体积、卵泡直径及子宫体积比较,差异无统计学意义(P>0.05)。治疗1年后,曲普瑞林组女童卵巢体积、卵泡直径及子宫体积均低于亮丙瑞林组(P<0.05)。治疗前,曲普瑞林组与亮丙瑞林组骨龄、生长速率及成熟度比较,差异无统计学意义(P>0.05)。治疗1年后,曲普瑞林组参与者生长速率及成熟度低于亮丙瑞林组(P<0.05)。治疗1年后两组骨龄比较,差异无统计学意义(P>0.05)。
对于ICPP女童,曲普瑞林在降低性激素水平、减小子宫体积、卵泡直径、卵巢体积、减缓生长速率及降低成熟度方面优于亮丙瑞林。治疗ICPP女童应优先选择曲普瑞林。