Jaruratanasirikul Somchit, Thaiwong Maethanee
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
J Pediatr Endocrinol Metab. 2011;24(7-8):519-23. doi: 10.1515/jpem.2011.006.
Central precocious puberty (CPP) is defined as pubertal development caused by activation of the hypothalamic-pituitary-gonadal axis before 8 years of age in girls and 9 years in boys. Failure to recognize and/or treat this condition can result in short adult stature.
To determine the etiology, clinical presentation and near-final height (NFH) of Thai children with CPP with or without gonadotropin-releasing hormone analog (GnRHa) treatment.
In a longitudinal observational study, 73 CPP patients who attended Songklanagarind Hospital between 1995 and 2009 were followed up every 3-6 months until they attained their NFH.
The etiologies observed were idiopathic CPP, hypothalamic hamartoma and central nervous system diseases. The mean age at time of diagnosis was 6.4 +/- 2.9 years. Bone age was on average 4 years more advanced than chronological age. Of the 52 patients who reached their NFH during the study, 32 were treated with GnRHa and 20 were not. The mean age at menarche was significantly greater for GnRHa-treated than for untreated girls (11.6 +/- 0.8 vs 10.1 +/- 1.1 years, p < 0.001). The median NFH of GnRHa-treated girls was 152.4 +/- 5.2 cm, which was significantly greater than the 144.4 +/- 5.0 cm for untreated girls (p < 0.001).
GnRHa treatment can preserve the genetic height potential of children with CPP.
中枢性性早熟（CPP）的定义为女孩8岁前、男孩9岁前因下丘脑-垂体-性腺轴激活而出现的青春期发育。未能识别和/或治疗这种情况可能导致成人身材矮小。
确定接受或未接受促性腺激素释放激素类似物（GnRHa）治疗的泰国CPP患儿的病因、临床表现及最终身高（NFH）。
在一项纵向观察性研究中，对1995年至2009年间在宋卡纳卡林医院就诊的73例CPP患者每3至6个月进行一次随访，直至达到其最终身高。
观察到的病因有特发性CPP、下丘脑错构瘤和中枢神经系统疾病。诊断时的平均年龄为6.4±2.9岁。骨龄平均比实际年龄超前4岁。在研究期间达到最终身高的52例患者中，32例接受了GnRHa治疗，20例未接受治疗。接受GnRHa治疗的女孩初潮平均年龄显著高于未治疗的女孩（11.6±0.8岁对10.1±1.1岁，p<0.001）。接受GnRHa治疗的女孩的中位最终身高为152.4±5.2厘米，显著高于未治疗女孩的144.4±5.0厘米（p<0.001）。
GnRHa治疗可保留CPP患儿的遗传身高潜力。
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