Study On Growth Deceleration In Children With Central Precocious Puberty Treated With Gonadotropin-releasing Hormone Analogs

Purpose:Gonadotropin-releasing hormone analogue?Gn Rha?is widely used in the treatment of idiopathic central precocious puberty?ICPP?,but in clinical work,some children in the treatment process of Gn Rha growth velocity is too low,influence the improvement of adult life in children with high,but for this phenomenon is related to factors influencing failed to detail,the research analysis of gonadotropin-releasing hormone?Gn Rha?in treatment of idiopathic central precocious girl growth slowdown and its influencing factors,at the same time observe Gn Rha in treatment of ICPP girl growth velocity too low,Combined use of Recombinant human growth hormone?Recombinant human growth hormone,after rh GH in growth velocity,growth velocity,GV?and predict adult lifetime high?predicted adult height,PAH?to improve the effect and changes in BMI.Method 1).Research analysis of gonadotropin-releasing hormone?Gn Rha?in the treatment of idiopathic central precocious puberty?idiopathic central precocious puberty,ICPP?in children with growth slowing down and its influencing factors:in May 2016 to June 2017 in our hospital diagnosed with ICPP,and then treated with Gn Rha full 2 years girl retrospective cohort study in 50 cases,observe the growth velocity,deceleration time,frequency,and analyze the growth velocity of the related factors.2).To analyze the improvement effect of Gn RHa combined with GH on GV and PAH in the treatment of ICPP with too low growth velocity:Were retrospectively analyzed in May 2016 to June 2018 visits our appear low growth velocity in the process of Gn RHa treatment?GV<4 cm/year?joint growth hormone to treat the complete ICPP girl 30 cases of medical records,observation of high growth velocity and predict adult life?PAH?in the diagnosis and treatment and follow-up,compared before and after growth velocity?GV?adjunctive therapy and predict adult lifetime high?PAH?change is statistically,and to investigate Gn RHa joint rh GH treatment a year later,the change of BMI,To elucidate the effect of Gn RHa combined with rh GH on Body mass index?BMI?.Results:1).Study and analysis of gonadotropin-releasing hormone?Gn Rha?in the treatment of children with idiopathic central precocious puberty?ICPP?and its influencing factors:The one-year growth velocity of ICPP girls before Gn Rha treatment was GV₀?7.61±1.69?cm/year.The growth velocity of the first year and the second year after receiving Gn Rha treatment were GV₁?6.72±1.93?cm/year,GV₂?5.65±1.44?cm/year,respectively.The annual growth velocity were statistically significant?F=38.261,P<0.01?,GV₀>GV₁>GV₂?all P<0.01?,and the growth velocity gradually decreased after treatment.When the correlation analysis of growth velocity was carried out,it was found that there was a negative correlation between earlier bone age?BA-CA?and the growth velocity of the first year?GV₁?.However,bone age,LH base value and LH peak value were negatively correlated with the growth velocity of the second year,and the correlation coefficients were-0.046,-0.047 and-0.007,respectively?all P values were<0.05?.Among them,the peak value of LH?P<0.01?was significantly correlated with the growth velocity of the second year?GV₂?,but GV₂was not correlated with the age,height,weight,ovarian volume and other factors at the first diagnosis.2).To analyze the effect of Gn RHa combined with GH on the improvement of GV,PAH and BMI in the treatment of ICPP girls with excessively low growth velocity:Combination with growth hormone?rh GH?the average growth velocity?GV_a?before treatment was 3.82 and 0.54 cm/year,predict adult life?PAH_a?was 150.2 and 4.2 cm high,growth velocity combination growth hormone therapy 12 months?GV_b?was 6.72 and 1.55 cm/year,predict adult life?PAH_b?was 159.6 and 5.1 cm high.There were statistically significant differences in GV and PAH before and after one year of growth hormone therapy?P<0.05?.According to BMI,25 children?83.3%?were normal weight at the beginning of Gn RHa+growth hormone therapy,and 5 children?16.7%?were overweight or obese,3 children were overweight during the treatment,and 2 children were overweight at the beginning of the treatment and subsequently reduced to normal weight.After Gn RHa+rh GH treatment for one year,the BMISDS_CAof ICPP children in the normal weight group increased,but the BMISDS_CAvalue of ICPP children in the overweight/obese group was not statistically significant.Conclusion:This study showed that during the treatment of Gn RHa in ICPP patients,the growth velocity gradually declined.However,girls with higher LH and older bone age at the first diagnosis were more likely to have slower growth in the second year of treatment.Children with low growth velocity were treated with Gn RHa,and combined growth hormone therapy could improve the prediction of lifelong adult height.However,BMI increased after 1 year of combined treatment for children with normal weight with ICPP.BMI changes should be closely monitored in the combined treatment with Gn RHa and rhGH.