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一项为期 1 个月和 3 个月的长效亮丙瑞林剂量治疗中枢性性早熟的随机试验。

A randomized trial of 1- and 3-month depot leuprolide doses in the treatment of central precocious puberty.

机构信息

Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

J Pediatr. 2011 Dec;159(6):982-7.e1. doi: 10.1016/j.jpeds.2011.05.036. Epub 2011 Jul 27.

Abstract

OBJECTIVE

To compare 1-month and 3-month depot formulations of leuprolide acetate (DL), a gonadotropin-releasing hormone analog, in the treatment of central precocious puberty (CPP).

STUDY DESIGN

Subjects with CPP naïve to therapy were randomized to 7.5 mg of 1-month DL, 11.25 mg of 3-month DL, or 22.5 mg of 3-month DL. Stimulated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and estradiol levels, growth velocity, and bone age progression were examined in a 2-year period.

RESULTS

Forty-nine female and 5 male subjects with CPP were randomized. Mean stimulated LH and FSH levels during treatment were higher in the low-dose 11.25-mg 3-month DL group, and more LH levels >4 IU/L were observed, in comparison with the other two dose groups. Mean LH and FSH levels in the 22.5-mg 3-month group were not different from the monthly DL. No differences in estradiol levels, growth velocity, or bone age progression were observed in dosing groups.

CONCLUSIONS

All DL doses resulted in prompt and effective suppression of puberty, but higher LH and FSH levels were seen with the 11.25-mg 3-month DL dose. Multi-monthly DL is effective in treating CPP, but higher dosing may be required in some circumstances.

摘要

目的

比较醋酸亮丙瑞林(DL)的 1 个月和 3 个月剂型在治疗中枢性性早熟(CPP)中的作用。

研究设计

对未接受过治疗的 CPP 患者进行随机分组,接受 7.5mg 1 个月 DL、11.25mg 3 个月 DL 或 22.5mg 3 个月 DL。在 2 年期间检测了受刺激的黄体生成素(LH)和卵泡刺激素(FSH)以及雌二醇水平、生长速度和骨龄进展情况。

结果

共有 49 名女性和 5 名男性 CPP 患者被随机分组。与其他两个剂量组相比,低剂量 11.25mg 3 个月 DL 组治疗期间受刺激的 LH 和 FSH 水平更高,且观察到更多的 LH 水平>4IU/L。22.5mg 3 个月 DL 组的 LH 和 FSH 水平与每月 DL 组无差异。在剂量组中,雌二醇水平、生长速度或骨龄进展均无差异。

结论

所有 DL 剂量均能迅速有效地抑制青春期,但 11.25mg 3 个月 DL 剂量会引起更高的 LH 和 FSH 水平。多剂量 DL 可有效治疗 CPP,但在某些情况下可能需要更高的剂量。

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