Antoniazzi F, Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino A M, Borrelli P, Osio D, Mengarda F, De Luca F, Tatò L
Pediatric Clinic, University of Verona, Italy.
J Pediatr Endocrinol Metab. 2000 Jul;13 Suppl 1:773-80. doi: 10.1515/jpem.2000.13.s1.773.
We report some end results with GnRH agonist (GnRHa) treatment in central precocious puberty (CPP), in terms of final height (FH), ovarian function, peak bone mass, body composition and psychological problems. The two studies reported (Study I and II) are part of the activity of the Italian Study Group for Physiopathology of Puberty. Study L Growth data were analyzed of three groups of patients: treated with i.n. spray buserelin, i.m. triptorelin and untreated. Both GnRHa administration modes were effective in arresting pubertal development and all girls had complete recovery of the reproductive axis after therapy. Treated patients showed an improvement in final height in comparison with untreated patients and compared to predicted height at the start of treatment with both agonist treatments. However, patients treated with the long-acting slow release preparation had a better improvement in adult height and reached or exceeded the genetic height potential. Study II. In a retrospective evaluation of the outcome in 71 girls with idiopathic CPP treated with triptorelin, we found that FH fell within the population norm and the target range in 87.3% and 90% of the patients respectively. The tallest FH was recorded in the patients who started therapy at less than 6 years of age and in those who discontinued treatment at a bone age of 12.0-12.5 yr. Finally, we and other groups have recently found normal values of bone mineral density in girls at the end of GnRHa treatment in the great majority of patients.
我们报告了促性腺激素释放激素激动剂(GnRHa)治疗中枢性性早熟(CPP)的一些最终结果,涉及最终身高(FH)、卵巢功能、峰值骨量、身体成分和心理问题。所报告的两项研究(研究I和研究II)是意大利青春期生理病理学研究小组活动的一部分。研究I:分析了三组患者的生长数据:接受鼻内喷雾布舍瑞林治疗、肌肉注射曲普瑞林治疗和未治疗的患者。两种GnRHa给药方式均能有效抑制青春期发育,所有女孩在治疗后生殖轴均完全恢复。与未治疗的患者相比,接受治疗的患者最终身高有所改善,并且与两种激动剂治疗开始时预测的身高相比也有所改善。然而,接受长效缓释制剂治疗的患者成年身高改善更好,达到或超过了遗传身高潜力。研究II:在对71例接受曲普瑞林治疗的特发性CPP女孩的结局进行回顾性评估中,我们发现分别有87.3%和90%的患者最终身高落在人群正常范围内和目标范围内。在小于6岁开始治疗的患者以及骨龄为12.0 - 12.5岁时停止治疗的患者中记录到最高的最终身高。最后,我们和其他研究小组最近发现,在大多数患者中,GnRHa治疗结束时女孩的骨密度值正常。