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The Effect of Height Improvement Treated with GnRHa and rhGH in Girls with Big Bone Age of Idiopathic Central Precocious Puberty

Author: LiuCaiHong
Tutor: LiGuiMei
School: Shandong University
Course: Pediatrics
Keywords: Idiopathic central precocious puberty Large bone age Gonadotropin-releasing hormone analogue ( of GnRHa ) Recombinant human growth hormone (rhGH) Height Expected height
CLC: R725.8
Type: Master's thesis
Year: 2011
Downloads: 51
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Background and Objective: gonadotropin releasing hormone analogue (GnRHa) significantly improved early in children with central precocious puberty lifelong [1] But some parents of precocious puberty lack of knowledge, when the doctor has missed the best timing of treatment, leading to predicted adult height maiden lt; 150cm, boy lt; 160cm; or to the bone age height SDS lt judgment; -2. The purpose of this study is to observe the GnRHa recombinant human growth hormone (rhGH) treatment effect on the big bone age with idiopathic central precocious puberty in female children with height. Subjects and methods: (1) object 2008.3-2011.3 treatment, Shandong Provincial Hospital pediatric endocrinologist clinic, bone age greater than 11.5 years ICPP girl as an object of study, the treatment time is longer than 12 months, a total of 30 cases. (2) treatment rhGH and GnRHa combination therapy: of GnRHa 80-100μg/kg (maximum 3.75mg) im or ih, the first and the second followed by an interval of 2 weeks, after the injection every four weeks; using rhGH 0.14 -0.20IU/kg.d, every night before going to bed subcutaneous injection. (3) observation of indicators of all patients were recorded genetic height (TH), height (H), weight (WT), bone age (BA), BMI (body mass index), PAH (predicted adult height), HtSDSBA (calculated according to bone age height standard deviation Points) HtSDSCA (height standard deviation integral calculated in accordance with the actual age), GV (growth rate). All the girls are doing the ovary and uterus B-All patients were fasting measured LH, FSH, E2, T, PRL, thyroid function and kidney function and biochemistry, parallel GnRHa stimulation test; every 3 months later height, weight, bone age and related to endocrine hormone levels. All girls do rapid progress hypothalamic - pituitary District NMR. Results: H: Height mean receiving combination therapy at 3, 6, 9, and 12 months, respectively (144.40 ± 3.30) cm, (147.50 ± 3.97) cm, (149.56 ± 4.76) cm, (152.13 ± 4.80) cm 6 (P lt; 0.05), 9 (P lt; 0.05), 12 (P lt; 0.01) mean height in the months before treatment were significantly increased. GV: 3 months after receiving combination therapy GV (11.36 1.40) cm, a significant increase compared with before treatment (P lt; 0.01), 6, 9 and 12 months after treatment, the GV and treatment before there was no statistically significant. Ht-SDS: children receiving combination therapy HtSDScA no significant change; HtSDSBA after treatment (P lt; 0.05), 12 (P lt; 0.01) months, a significant increase. PAH: children receiving GnRH with rhGH joint before treatment TH mean (156.43 ± 1.99) cm of PAH mean (149.56 ± 4.18) cm the PAH-TH (-6.87 ± 4.45) cm. After receiving combination therapy month 9 (P lt; 0.05), 12 (P lt; 0.01) the PAH mean than before treatment significantly improved. PAH-TH value months after receiving combination therapy 6 (P lt; 0.05), 9 (P lt; 0.05), 12 (P lt; 0.05) were significantly increased. BMI: children receiving combination therapy compared to 3, 6, 9, and 12 months, the mean BMI than before treatment were not significantly different. Correlation study: 1) patients received GnRH combined treatment with rhGH height growth (△ Ht) and treatment time (t) correlation, r = 0.95, P = 0.00, showed a significant linear correlation. 2) patients received of GnRH with rhGH treatment HtSDSBA treatment time (t) correlation study, r = 0.65, P = 0.00, showed a significant linear correlation. 3) patients received GnRH with rhGH treatment of PAH, correlation studies and treatment time (t), r = 0.673, P = 0.00, showed a significant positive correlation. 4) patients received △ PAH after GnRH treatment with rhGH treatment time (t) correlation study, r = 0.937, P = 0.00, was significantly positively correlated .5) patients received GnRH with rhGH treatment PAH-TH and treatment time (t) correlation, r = 0.62, P = 0.00, and was a significant positive correlation. Conclusion: a joint GnRHa and rhGH treatment, bone age women with idiopathic central precocious puberty in children can significantly improve their expected height (PAH); longer the duration of treatment, the greater the expected height improvement. 2 children receiving combination therapy early growth acceleration period, the the late growth speed is normal. 3 combination therapy had no significant effect on body mass index in children.

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CLC: > Medicine, health > Pediatrics > Children within the science > Pediatric endocrine diseases and metabolic diseases
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