本文選題：早初潮 + 促性腺激素釋放激素類(lèi)似物　； 參考：《中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版)》2017年03期

【摘要】：【目的】探討早初潮女孩及應(yīng)用過(guò)促性腺激素釋放激素類(lèi)似物(GnRHa)治療的女孩代謝和性腺軸的改變�！痉椒ā窟x取我院因早初潮就診39例,曾應(yīng)用GnRHa治療并已呈現(xiàn)初潮女孩58例作為研究對(duì)象,并以正常初潮19例作為對(duì)照。測(cè)量身高、體重,B超測(cè)量子宮、卵巢大小,抽血查性激素及胰島素、血糖、血脂、leptin、adiponectin等代謝指標(biāo)�！窘Y(jié)果】早初潮女孩年齡別和骨齡別體質(zhì)指數(shù)標(biāo)準(zhǔn)差分值(BMISDS)均較正常初潮女孩顯著增高(P0.05),發(fā)生胰島素抵抗的比例(20.5%)亦較正常初潮女孩(0%)顯著升高,而脂代謝和性腺軸各項(xiàng)指標(biāo)均無(wú)差異。GnRHa治療者初潮后BMISDS和胰島素、HOMA-IR及發(fā)生胰島素的比例(20.7%)均較正常初潮組顯著升高(P0.05);同時(shí),DHEAS、雄烯二酮和睪酮均較早初潮組高,子宮體積較正常和早初潮組顯著增大。【結(jié)論】早初潮及GnRHa治療有可能對(duì)BMI和糖代謝產(chǎn)生負(fù)面影響,GnRHa治療者還伴雄激素分泌功能相對(duì)稍亢進(jìn)。因此,建議早初潮女孩應(yīng)監(jiān)測(cè)胰島素、血糖等糖代謝指標(biāo),GnRHa治療的患兒應(yīng)從治療開(kāi)始一直監(jiān)測(cè)糖代謝指標(biāo)至初潮后,從而早期發(fā)現(xiàn)、早期治療可能存在的高胰島素血癥。
[Abstract]:[objective] to investigate the changes of metabolism and gonadal axis in girls with early menarche and those who had been treated with gonadotropin releasing hormone analogue (GnRHa). [methods] 39 cases of early menarche in our hospital were selected.58 cases of girls with menarche were treated with GnRHa and 19 cases of normal menarche were used as control.Measure height, weight, size of uterus and ovary, measure sex hormone, insulin, blood sugar,[results] the BMISDSs of age and bone age of early menarche girls were significantly higher than those of normal menarche girls (P 0.05), and the proportion of insulin resistance (20. 5%) was significantly higher than that of normal menarche girls.However, there was no difference in lipid metabolism and gonadal axis. The levels of BMISDS, HOMA-IR and the ratio of insulin to insulin in the patients with menarche were significantly higher than those in the normal menarche group, and the levels of DHEAS, androstenedione and testosterone were higher than those in the early menarche group.[conclusion] early menarche and GnRHa therapy may have a negative effect on BMI and glucose metabolism.Therefore, it is suggested that early menarche girls should be monitored for insulin, glucose and other glucose metabolism indexes. The children treated with GnRHa should monitor glucose metabolism from the beginning of treatment to after menarche, so as to find the possible hyperinsulinemia in early treatment.
【作者單位】： 中山大學(xué)附屬第一醫(yī)院兒科;
【基金】：廣東省醫(yī)學(xué)科研基金(A2015303)
【分類(lèi)號(hào)】：R725.8

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