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[睾酮治疗青春期延迟:与对照组相关的纵向研究]

[Testosterone treatment of delayed puberty: a longitudinal study in relation to a control group].

作者信息

Llop Viñolas D, Vizmanos Lamotte B, Aresté Piztzalis A, Soler Pérez J L, Martí-Henneberg C

机构信息

Servicio de Pediatría del Hospital Universitario Sant Joan, Universidad Rovira i Virgili, Reus, Tarragona.

出版信息

An Esp Pediatr. 1999 Oct;51(4):346-52.

Abstract

OBJECTIVE

Delayed puberty is a very common clinical situation that affects a great number of adolescents. We analyzed the effects that testosterone therapy produces in this situation, including the start of puberty and, therefore, lessening the psychological effects that this delay causes.

PATIENTS AND METHODS

We carried out a longitudinal study, in which we followed the growth and maturation of 32 boys from the age of 14 to 19 years. The sample was divided into a control group (n = 17) and a treatment group (n = 15). The treatment group received 50 mg/month of testosterone enantate depot during 6 months. None of the subjects, neither in the control group nor in the treatment group, had started puberty or if so, they had started it in an insufficient way for their age.

RESULTS

The boys treated with testosterone developed a greater growth velocity compared to the control group during the first year of observation (9.07 +/- 1.11 cm/year vs 6.9 +/- 1.76, respectively, p < 0.0001). They had a higher increment in the muscular area of the arm (p < 0.005) and pubertal stage G changes occurred more quickly. On the other hand, the growth of the testicular volume was similar in both groups. At 19 years of age, no significant difference between the groups was observed in any of the clinical parameters studied.

CONCLUSIONS

Treatment wit testosterone at the dose used promotes a significant response that leads to the start of puberty, but without stopping the maturation of the hypothalamic-pituitary axis that is produced in normal puberty, allowing a normal testicular evolution. The treatment does not show any long-term effects. It is, therefore, an effective treatment of delayed puberty.

摘要

目的

青春期延迟是一种非常常见的临床情况,影响着大量青少年。我们分析了睾酮治疗在这种情况下产生的效果,包括青春期启动,从而减轻这种延迟所造成的心理影响。

患者与方法

我们进行了一项纵向研究,跟踪了32名14至19岁男孩的生长和成熟情况。样本分为对照组(n = 17)和治疗组(n = 15)。治疗组在6个月内每月接受50毫克庚酸睾酮长效注射剂。对照组和治疗组的受试者均未开始青春期发育,或者即便开始了,其发育程度也与其年龄不相符。

结果

在观察的第一年,接受睾酮治疗的男孩与对照组相比,生长速度更快(分别为9.07±1.11厘米/年和6.9±1.76厘米/年,p < 0.0001)。他们手臂肌肉面积的增加更大(p < 0.005),青春期G分期变化更快。另一方面,两组睾丸体积的增长相似。在19岁时,所研究的任何临床参数在两组之间均未观察到显著差异。

结论

使用该剂量睾酮进行治疗可产生显著反应,促使青春期启动,但不会阻止正常青春期时发生的下丘脑 - 垂体轴成熟,从而使睾丸正常发育。该治疗未显示出任何长期影响。因此,它是一种治疗青春期延迟的有效方法。

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