Ságodi László, Sólyom Enikő, Lombay Béla, Almási Andrea, Vámosi Ildikó
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház III. Csecsemő- és Gyermekosztály Miskolc Pf. Miskolci Egyetem, Egészségügyi Kar Védőnői Tanszék Miskolc.
Orv Hetil. 2012 Mar 18;153(11):418-24. doi: 10.1556/OH.2012.29320.
It has been proven for more than two decades that gonadotropin releasing hormone analogue therapy is the only choice of treatment in patients with central precocious puberty.
The aim of the authors was to assess the effect of gonadotropin releasing hormone analogue treatment on final height, body mass index, bone mineral density and ovarian function in girls with idiopathic central precocious puberty.
Predicted adult height, target height and achieved height due to therapy was assessed in 15 girls with idiopathic precocious puberty treated with gonadotropin releasing hormone analogue. At the beginning of the treatment, the age of the girls was 7.0±0.8 years (mean±SD) and at the end of the treatment 12±0.8 years. The duration of gonadotropin-releasing hormone analogue treatment was 4.48±0.8 years. At the time of achieving final height, the age of the patients was 18.2±2.0 years and the height was 160.4±7.1 cm. When final height was reached, the authors evaluated bone mineral density Z-score values, levels of bone markers and the function of the hypothalamic-pituitary-gonadal axis. 15 healthy prepubertal girls, 15 pubertal girls and 15 girls who reached final height matched for chronological age were selected as control groups.
The majority of the gonadotropin releasing hormone-treated girls reached or almost reached their expected height predicted on the basis of the heights of their parents, but the therapy resulted only in a modest beneficial effect on height gain. Despite the fact that the body weight of patients increased during the treatment, there was no significant difference in their body mass index when they reached their final height as compared to controls. As compared to controls, patients had a decreased bone mineral density at the time when they reached their final height (lumbar spine 2-4 Z score, -0.27±1.2 vs. 0.5±0.7 in controls; p = 0.0377), which could be explained by their overweight that already existed before treatment, lack of exercise and poor calcium uptake. Their menarche occurred 12±4.6 months after discontinuing the treatment.
Gonadotropin releasing hormone analogue therapy exerts a modest beneficial effect on final height gain. There are no detrimental effects on body mass index, bone mineral density and ovarian function after treatment. Side-effects are of minor severity and they are tolerable.
二十多年来已证实，促性腺激素释放激素类似物疗法是中枢性性早熟患者的唯一治疗选择。
作者旨在评估促性腺激素释放激素类似物治疗对特发性中枢性性早熟女孩最终身高、体重指数、骨密度和卵巢功能的影响。
对15例接受促性腺激素释放激素类似物治疗的特发性性早熟女孩评估治疗后的预测成年身高、靶身高和实际身高。治疗开始时，女孩年龄为7.0±0.8岁（均值±标准差），治疗结束时为12±0.8岁。促性腺激素释放激素类似物治疗持续时间为4.48±0.8年。达到最终身高时，患者年龄为18.2±2.0岁，身高为160.4±7.1厘米。达到最终身高时，作者评估了骨密度Z评分值、骨标志物水平以及下丘脑 - 垂体 - 性腺轴的功能。选择15例健康青春期前女孩、15例青春期女孩和15例按年龄匹配达到最终身高的女孩作为对照组。
大多数接受促性腺激素释放激素治疗的女孩达到或几乎达到基于其父母身高预测的预期身高，但该疗法对身高增长仅产生适度的有益影响。尽管患者体重在治疗期间增加，但达到最终身高时其体重指数与对照组相比无显著差异。与对照组相比，患者达到最终身高时骨密度降低（腰椎2 - 4 Z评分，-0.27±1.2 vs. 对照组0.5±0.7；p = 0.0377），这可能是由于治疗前就已存在超重、缺乏运动和钙摄入不足所致。她们在停止治疗后12±4.6个月月经初潮。
促性腺激素释放激素类似物疗法对最终身高增长有适度的有益影响。治疗后对体重指数、骨密度和卵巢功能无有害影响。副作用程度较轻且可耐受。
