Abstract: Objective To explore the dynamic changes and clinical value of bone metabolic index after gonadotrophin releasing hormone analogue (GnRHa) treatment in girls with central precocious puberty(CPP),in order to provide scientific reference for clinical treatment. Methods Totally 36 CPP girls treated with GnRHa and 36 healthy girls as controls were enrolled in this study from October 2015 to June 2016,and were tested for serum bone mineralogy,bone formation and common serum levels before treatment and 6 months,12 months,18 months and 24 months after treatment. Bone resorption marker levels were compared in groups and different time points. Results At the end of the study,the observation group lost 5 (13.89%) cases,and the control group lost 4(11.11%) cases. There were no significant differences on blood Ca,P,25-(OH)D₃ and β-CTX between CPP group and control group at each time point after treatment (P＞0.05). Blood E2,N-MID OC,P1NP and BALP decreased gradually after treatment,and there was statistically significant difference between CPP group and control group at each time point (P<0.05). Conclusions Estrogen level in children is significantly reduced during the first 12 months of treatment with GnRHa. And the effect of GnRHa on osteoblasts is more pronounced than that on osteoclasts.

Key words: central precocious puberty, gonadotrophin releasing hormone analogue, bone metabolic index, bone reconstruction

摘要： 目的 探讨中枢性性早熟(CPP)女童GnRHa治疗后骨代谢指标的动态变化情况和临床意义,为临床治疗提供科学依据。方法 选取2015年10月-2016年6月在昆明市儿童医院接受GnRHa治疗的36例中枢性性早熟女童和36例健康女童作为对照,检测治疗前和治疗后6、12、18、24个月两组女童常见的血清骨营养指标、骨形成和骨吸收标志物水平,比较组间和不同时点各指标的差异。结果 研究结束,观察组失访5例(失访率13.89%),对照组失访4例(失访率11.11%)。血Ca、P、25-(OH)D₃、β-CTX4Ⅲ项指标治疗后各时点与治疗前差异无统计学意义(P>0.05),各时点组间比较差异无统计学意义(P＞0.05),血E2、N-MID OC、P1NP、BALP4Ⅲ项指标治疗后逐渐下降,且各时点组间比较差异有统计学意义(P<0.05)。结论 GnRHa治疗的最初12月内,患儿雌激素水平下降较明显。GnRHa对成骨细胞的作用较破骨细胞明显

关键词: 中枢性性早熟, 促性腺激素释放激素类似物, 骨代谢指标, 骨重建