Rosenfeld R G
Department of Pediatrics, Stanford University School of Medicine, California 94305.
Acta Paediatr Suppl. 1992 Sep;383:3-6; discussion 7.
The Genentech National Cooperative Study of growth hormone (GH) therapy in Turner's syndrome was initiated in 1983; 70 girls with Turner's syndrome were randomly assigned to observation or to treatment with GH alone, oxandrolone alone, or a combination of GH plus oxandrolone for a period of 12-24 months. After completion of this phase, patients receiving GH alone were continued on GH, while all other patients received the combination of GH plus oxandrolone. Data are currently available on the 62 girls who were treated for a minimum of 3-6 years. When compared with the height velocities anticipated for girls of comparable ages with untreated Turner's syndrome, both GH alone and a combination of GH plus oxandrolone resulted in an increase in height velocity, which was most prominent during the first 2 years of treatment and was sustained for at least 6 years. Although GH therapy is continuing at present in half of the patients, 14 of 17 girls (82%) receiving GH alone and 42 of 45 girls (93%) receiving combination therapy have exceeded their projected adult heights. For the 30 girls who have stopped therapy, the current mean height is 151.9 cm, compared with their original mean projected adult height of 143.8 cm. These results demonstrate that GH therapy can result in short-term (3-6 years) acceleration of growth, as well as in improved adult height.
基因泰克公司关于特纳综合征生长激素(GH)治疗的全国合作研究始于1983年;70名特纳综合征女孩被随机分配至观察组,或接受单独使用GH、单独使用氧雄龙,或GH加氧雄龙联合治疗,为期12 - 24个月。此阶段结束后,单独接受GH治疗的患者继续使用GH,而所有其他患者接受GH加氧雄龙联合治疗。目前已有62名接受至少3 - 6年治疗的女孩的数据。与未接受治疗的特纳综合征同龄女孩预期的身高增长速度相比,单独使用GH以及GH加氧雄龙联合治疗均使身高增长速度加快,这在治疗的前两年最为显著,并持续至少6年。尽管目前仍有半数患者在接受GH治疗,但单独接受GH治疗的17名女孩中有14名(82%)、接受联合治疗的45名女孩中有42名(93%)已超过其预计的成人身高。对于30名已停止治疗的女孩,目前的平均身高为151.9厘米,而她们原来预计的成人平均身高为143.8厘米。这些结果表明,GH治疗可导致短期(3 - 6年)生长加速,以及提高成人身高。