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中枢性性早熟患者使用缓释促性腺激素释放激素激动剂治疗期间及治疗后的生长与青春期发育

Growth and pubertal development during and after treatment with a slow-release gonadotropin-releasing hormone agonist in central precocious puberty.

作者信息

Oostdijk W, Gevers E F, Drop S L, Rikken B, Hümmelink R, Partsch C J, Sippell W G

机构信息

Department of Pediatrics, University of Leiden, The Netherlands.

出版信息

Horm Res. 1991;36(3-4):121-5. doi: 10.1159/000182144.

Abstract

The auxological data of 25 patients (21 girls, 4 boys) with central precocious puberty (CPP), treated for 4 years with a slow-release gonadotropin-releasing hormone agonist [Decapeptyl-controlled release (D-CR) 3.75] every 4 weeks intramuscularly, and of 6 patients (3 girls, 3 boys), treated for 5 years, are presented. After 3 years of D-CR a stabilization of height velocity (HV) at about 4 cm/year was observed. Bone maturation (ratio of change in bone age to change in chronological age; delta BA/delta CA) slowed down to a mean delta BA/delta CA ratio of 0.5 +/- 0.2 (mean +/- SD) measured over 48 months. As a result, predicted adult height (PAH) improved from 156.3 +/- 7.4 to 162.2 +/- 6.8 cm in girls (p less than 0.001) and from 174.4 +/- 18.6 to 184.3 +/- 17.1 cm in boys after 4 years. In the 5th year an ongoing improvement of PAH was observed. 20 additional girls discontinued D-CR for at least 12 months after treatment with D-CR for 2 years or more. In 11 girls menses started after 10.6 +/- 3.1 months; 9 girls had no menarche after 12-16 months. HV increased in the first and second 6 months to a level of about 6.0 cm/year, decreased in the third 6 months after cessation to the level before discontinuing D-CR and decreased further afterwards. Bone maturation (delta BA/delta CA) increased progressively in the first 18 months after discontinuation, with a stabilization at about 1.3. PAH did not change in the first 12 months after discontinuation of D-CR, but showed a decrease afterwards.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文呈现了25例中枢性性早熟(CPP)患者(21名女孩,4名男孩)和6例患者(3名女孩,3名男孩)的生长学数据。25例患者每4周肌肉注射一次缓释促性腺激素释放激素激动剂[曲普瑞林控释剂(D-CR)3.75],治疗4年;6例患者治疗5年。使用D-CR 3年后,观察到身高增长速度(HV)稳定在每年约4厘米。骨成熟度(骨龄变化与实际年龄变化的比值;ΔBA/ΔCA)减慢,在48个月内测得的平均ΔBA/ΔCA比值为0.5±0.2(平均值±标准差)。结果,4年后女孩的预测成年身高(PAH)从156.3±7.4厘米提高到162.2±6.8厘米(p<0.001),男孩从174.4±18.6厘米提高到184.3±17.1厘米。在第5年,观察到PAH持续改善。另外20名女孩在接受D-CR治疗2年或更长时间后停药至少12个月。11名女孩在10.6±3.1个月后月经初潮;9名女孩在12 - 16个月后无月经初潮。停药后的前6个月和第二个6个月,HV增加到约6.0厘米/年的水平,在停药后的第三个6个月降至停药前的水平,并在之后进一步下降。停药后的前18个月,骨成熟度(ΔBA/ΔCA)逐渐增加,稳定在约1.3。停药后的前12个月,PAH没有变化,但之后出现下降。(摘要截断于250字)

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