Messaaoui A, Massa G, Tenoutasse S, Heinrichs C
Service de Pédiatrie, Unité d'Endocrinologie Pédiatrique, Hôpital Universitaire des Enfants Reine Fabiola, ULB.
Rev Med Brux. 2005 Feb;26(1):27-32.
Central precocious puberty (CPP) is treated with GnRH analogues to stabilize secondary sexual characteristics and to prevent loss of final height (FH) due to accelerated bone maturation. However, some studies suggest that FH is not always improved and that treatment may induce excessive weight gain. We analysed data from 19 girls treated for CPP with monthly injections of 3.75 mg triptorelin. Pubertal development, bone age, height, weight and body mass index (BMI) were evaluated at start (chronological age: 7.8 +/- 1.8 yrs, mean +/- SD), at the end of treatment (10.6 +/- 1.1 yrs) and at FH (14.9 +/- 2.5 yrs). At start of treatment, breast (B) development was B3 (from 2 to 4), bone age 10.6 +/- 1.7 yrs, height 2.1 +/- 1.1 SDS and BMI 1.3 +/- 0.8 SDS. Treatment stabilized or reduced breast development and decreased bone maturation. Final height was 162.3 +/- 6.6 cm (0.0 +/- 1.1 SDS) and was comparable to predicted adult height at the start of treatment and to corrected mid-parental height. BMI SDS at the start, the end of treatment and at final evaluation were 1.3 +/- 0.8, 1.6 +/- 0.8 and 1.4 +/- 0.9 SDS. In conclusion, in our girls with central precocious puberty, treatment with GnRH agonist stabilized or decreased breast development and stabilized bone maturation, but did not increase neither final height nor weight. Aspects other than height should also be taken into account when considering treatment of children with precocious puberty.
中枢性性早熟（CPP）采用促性腺激素释放激素（GnRH）类似物进行治疗，以稳定第二性征，并防止因骨成熟加速导致最终身高（FH）受损。然而，一些研究表明，最终身高并不总是得到改善，而且治疗可能会导致体重过度增加。我们分析了19名接受每月注射3.75 mg曲普瑞林治疗CPP的女孩的数据。在治疗开始时（实际年龄：7.8±1.8岁，均值±标准差）、治疗结束时（10.6±1.1岁）以及达到最终身高时（14.9±2.5岁），对青春期发育、骨龄、身高、体重和体重指数（BMI）进行了评估。治疗开始时，乳房（B）发育为B3期（2至4期），骨龄为10.6±1.7岁，身高为2.1±1.1标准差分值（SDS），BMI为1.3±0.8 SDS。治疗稳定或减少了乳房发育，并减缓了骨成熟。最终身高为162.3±6.6 cm（0.0±1.1 SDS），与治疗开始时预测的成人身高以及校正后的父母平均身高相当。治疗开始时、结束时以及最终评估时的BMI SDS分别为1.3±0.8、1.6±0.8和1.4±0.9 SDS。总之，在我们这些中枢性性早熟的女孩中，GnRH激动剂治疗稳定或减少了乳房发育，并稳定了骨成熟，但既未增加最终身高，也未增加体重。在考虑对性早熟儿童进行治疗时，还应考虑身高以外的其他因素。
