| Objective:In recent years,with the progress of society,the incidence of precocious puberty in children is increasing year by year.Triptorelin is the first choice for the treatment of ICPP drugs at home and abroad,triptorelin can inhibit its own secretion of GnRH,reduce pituitary gonadotropin secretion,thereby inhibiting or delaying gonadal development.The aim of this study was to compare the indexes of height,weight,BMI,gonadal(uterine)and uterine changes of GnRHa before and after treatment of GnRHa to improve the final height of children.Methods:Twenty girls who were diagnosed as idiopathic central precocious puberty were enrolled in the Department of Pediatric Endocrinology,Second Affiliated Hospital of Hebei Medical University from 2014 to 2016.The growth rate was higher than that of normal children;bone age was advanced;gonadal enlargement: intracavitary pelvic ultrasound showed that the girl’s uterus and ovary were(ICMA)measured LH peak ≥ 5.0U / L,while GnRHa excitation test LH peak / FSH peak> 0.6,the number of cells in the ovary can be seen in a number of> 4 mm diameter follicles;HPGA functional start,Serum LH,FSH and E2 levels were measured by chemiluminescence method before and after treatment with triptorelin acetate.GnRHa challenge test was performed.The intrauterine ultrasonography was used to observe the uterine volume(length * width * thickness * 0.523),FCR(uterine anteroposterior diameter / cervix anteroposterior diameter),ovarian volume(length * width * thickness * 0.523),given triptorelin acetate 60 ~ 160 ug /(kg · 5 weeks),every three months,Body weight and intracavitary pelvic ultrasound were detected and recorded.The variance analysis,ovarian volume,uterine volume,uterine diameter,diameter of the cervix,vaginal wall thickness,BMI and so on were analyzed by SPSS16.0 software.The results showed that there was no significant difference between the two groups.Test,ovarian volume,uterine volume and other BMI correlation analysis using Pearson correlation analysis.To evaluate the clinical effect of triptorelin in the treatment of idiopathic central precocious puberty in girls by changes in related parameters.Results: 1 20 cases of ICPP girls age(8.4 ± 1.23)years old,minimum 6.5 years old,maximum 10 years old.20 girls after treatment,the second sexual characteristics are different degrees of retraction.2 Height growth:(2.24 ± 0.877)cm / month in the first 3 months after treatment,height growth at(3)to 6 months(1.71 ± 0.686)cm / month,statistic analysis of variance(F=3.135,P=0.139>0.05),no statistically significant.Considering the uniform growth during the treatment.3 By rectal pelvic ultrasound 3.1 Ovarian volume: before the treatment(2.84 + 1.47)cm3,left for the 3 months after treatment(1.70 + 1.32)cm3,and 6 months after treatment(1.63 + 0.89)cm3;Right before the treatment(3.58 + 1.75)cm3,after treatment for 3 months(2.06 + 1.44)cm3,6 months after treatment(1.78 + 1.43)cm3.3 months and 6 months after treatment compared with before treatment were significantly reduced,there is statistical significance,the left side(t = 3.734,P = 3.734 < 0.05),(t = 3.636,P = 3.636 < 0.05),on the right side(t = 3.659,P = 3.659 < 0.05),(t = 3.820,P = 3.820 < 0.05).3.2 Ovary length to diameter : before the left side of the treatment(2.281 + 0.391)cm,3 months after treatment(1.889 + 0.393)cm,6 months after treatment(1.838 + 0.365)cm;Right before the treatment(2.320 + 0.393)cm,3 months after treatment(2.002 + 0.50)cm;6 months after treatment(1.828 + 0.353)cm.3 months and 6 months after treatment compared with before treatment were significantly reduced,there is statistical significance,the left side(t = 3.287,P = 3.287 < 0.05),(t = 3.818,P = 3.818 < 0.05),on the right side(t = 3.216,P = 3.216 < 0.05),(t = 5.262,P = 5.262 < 0.05).3.3 Uerine diameter: before treatment(2.40 ± 0.70)cm,3 months after treatment(2.02 ± 0.538)cm,6 months after treatment(1.978 ± 0.379)cm.(T =-3.209,P = 0.05),(t =-3.560,P = 0.002 <0.05),and the difference was statistically significant at 3 months and 6 months after treatment.3.4 Bilateral vaginal thickness: before treatment(0.242 ± 0.08)cm,3 months after treatment(0.258 ± 0.23)cm,6 months after treatment(0.206 ± 0.0619)cm.There was no significant difference between the three months and six months after treatment(t =-0.327,P = 0.747> 0.05)(t = 1.70,P = 1.015> 0.05).3.5 Cervical diameter: before treatment(1.83 ± 0.474)cm,3 months after treatment(1.55 ± 0.449)cm;6 months after treatment(1.52 ± 0.288)cm.(T =-3.295,P = 0.004 <0.05),(t =-3.913,P = 0.001 <0.05),which was statistically significant at 3 months and 6 months after treatment.3.6 Uterine volume: before treatment(5.80 ± 4.38)cm3,after treatment in March(3.62 ± 2.92)cm3,after treatment in June(3.03 ± 1.92)cm3.6 months after treatment and before treatment was statistically significant(Z = 3.435,P = 0.01 <0.005).3.7 Uterine FCR: FCR before treatment(1.30 ± 0.275),after treatment in March(1.30 ± 0.373),after treatment in June(1.26 ± 0.279),by statistical t test analysis before and after treatment was not obvious,no statistics significance.4 BMI: before treatment(18.05 ± 2.630),3 months after treatment(18.15 ± 2.427),6 months after treatment(18.86 ± 2.427).6 months after treatment and significantly increased before treatment,statistically significant,(t = 3.615,P = 0.007 <0.05).5 Girls into the group before treatment of uterine volume,left ovarian volume,right ovarian volume,vaginal thickness,uterine FCR,uterine size related parameters and BMI was analyzed by Pearson correlation was not statistically significant,right ovary volume positively correlated with BMI index,significant correlation(r=0.892,P=0.031 < 0.05).Conclusions:1 Triptorelin can inhibit the development of delayed gonadal and secondary sexual characteristics,the size of the ovary,the length of the ovary,uterine volume,the length of the uterus and the length of the cervix can rise early response to treatment;2 Before and after the treatment of precocious puberty,there was no significant change in the vaginal wall thickness and the FCR of the uterus;3 The treatment of ICPP girls treated with resulted in a constant increase in height within the first 6 months;4 Triptrein may cause a BMI increase in children. |
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