Wacharasindhu Suttipong, Srivuthana Sumarlee, Aroonparkmongkol Suphab, Supornsilchai Vichit, Hiranrat Paravee, Yodvisitsak Viraporn
Endocrine Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
J Med Assoc Thai. 2003 Jun;86 Suppl 2:S170-3.
Gonadotropin releasing hormone (GnRH) agonist has been used worldwide for the treatment of central precocious puberty. However, the results on final adult height (FAH) are discrepant in various studies especially in girls with normal early puberty. Fourteen girls with normal early puberty who were treated with depot GnRH agonists 3.75 mg intramuscular (i.m.) monthly for a mean period of 1.5 +/- 0.4 yr were retrospectively studied. The chronological age and bone age at the beginning of treatment were 9.9 +/- 0.7 yr and 12.6 +/- 0.9 yr, respectively. When the treatment was stopped, all the girls were followed-up until they reached their final adult heights. The results showed that the mean FAH was 154.0 +/- 6.9 cm, which was not significantly different from the predicted adult height (PAH) at start of treatment, 153.1 +/- 6.2 m. All the girls were divided into 2 groups. Group A was girls who had FAH-PAH at the start of treatment > or = 1.5 cm and group B, FAH-PAH at the start of treatment < 1.5 cm. The authors found that only the duration of treatment was different between these 2 groups, 1.7 +/- 0.3 yr in group A and 1.3 +/- 0.3 yr in group B (p = 0.015). In conclusion, GnRH agonist cannot improve the final height outcome in girls with normal early puberty. However, a longer period of treatment may improve the height prognosis.
促性腺激素释放激素（GnRH）激动剂已在全球范围内用于治疗中枢性性早熟。然而，不同研究中关于最终成年身高（FAH）的结果存在差异，尤其是在青春期发育正常的女孩中。对14名青春期发育正常的女孩进行了回顾性研究，这些女孩每月接受3.75毫克长效GnRH激动剂肌肉注射（i.m.），平均治疗时间为1.5±0.4年。治疗开始时的实际年龄和骨龄分别为9.9±0.7岁和12.6±0.9岁。治疗停止后，对所有女孩进行随访直至达到最终成年身高。结果显示，平均最终成年身高为154.0±6.9厘米，与治疗开始时预测的成年身高（PAH）153.1±6.2厘米相比，无显著差异。所有女孩分为两组。A组为治疗开始时最终成年身高减去预测成年身高≥1.5厘米的女孩，B组为治疗开始时最终成年身高减去预测成年身高＜1.5厘米的女孩。作者发现，两组之间仅治疗持续时间不同，A组为1.7±0.3年，B组为1.3±0.3年（p = 0.015）。总之，GnRH激动剂不能改善青春期发育正常女孩的最终身高结局。然而，较长时间的治疗可能改善身高预后。
