Gordon D, Lauder J C, Cohen H N, O'Donnell A M, Semple C G, Thomson J A
University Department of Medicine, Royal Infirmary, Glasgow.
Q J Med. 1990 Mar;74(275):247-56.
Fifty male patients with delayed pubertal development (chronological age 13.3-17.6 years; bone age 9.5-14 years) were treated with human chorionic gonadotrophin (HCG) 1500-2000 units twice weekly for six months to promote pubertal development and accelerate growth. Response was compared with an untreated control group of 28 patients (chronological age 12.5-17.5 years; bone age 7.0-13.0 years). Forty-four of 46 patients in the treatment group achieved genital stage 3 or 4 by the end of therapy; untreated patients either remained unchanged or advanced only one genital stage during this period. Testicular volumes increased from a median 4.5 ml (range 1-12 ml) to 9 ml (range 3.5-15 ml) in the treated patients. In untreated patients testicular volume increased from 6.0 ml (range 2-10 ml) to 9.5 ml (range 4-20 ml) over the same period. In patients initially growing at less than 7.0 cm/year height velocity increased from 3.9 cm/year (range 0-6.6 cm/year) to 12.7 cm/year (range 8.9-16.8 cm/year) during therapy, falling to 6.0 cm/year (range 0-12 cm/year) in the three-month period immediately following treatment. Patients initially growing at greater than 7.0 cm/year showed variable responses to treatment. Prepubertal patients showed the greatest acceleration in annual growth compared with controls. Treated patients with an initial skeletal age less than 12.0 years showed either a final height (when known) which was less than initially predicted or a significant reduction in predicted height following treatment. Skeletal age greater than 12.0 years was not associated with excess osseous maturation. In conclusion, pre-pubertal children growing at less than 7 cm/year show the greatest benefit from HCG therapy, but final height may be prejudiced if initial bone age is less than 12 years.
五十名青春期发育延迟的男性患者（实际年龄13.3 - 17.6岁；骨龄9.5 - 14岁）接受了人绒毛膜促性腺激素（HCG）治疗，每周两次，每次1500 - 2000单位，共六个月，以促进青春期发育并加速生长。将治疗反应与28名未治疗的对照组患者（实际年龄12.5 - 17.5岁；骨龄7.0 - 13.0岁）进行比较。治疗组的46名患者中有44名在治疗结束时达到生殖器3期或4期；在此期间，未治疗的患者要么保持不变，要么仅前进一个生殖器阶段。治疗患者的睾丸体积从中位数4.5毫升（范围1 - 12毫升）增加到9毫升（范围3.5 - 15毫升）。在未治疗的患者中，同期睾丸体积从6.0毫升（范围2 - 10毫升）增加到9.5毫升（范围4 - 20毫升）。对于最初身高增长速度低于7.0厘米/年的患者，治疗期间身高增长速度从3.9厘米/年（范围0 - 6.6厘米/年）增加到12.7厘米/年（范围8.9 - 16.8厘米/年），在治疗后的三个月内降至6.0厘米/年（范围0 - 12厘米/年）。最初身高增长速度高于7.0厘米/年的患者对治疗的反应各不相同。与对照组相比，青春期前患者的年生长加速最为明显。初始骨龄小于12.0岁的治疗患者，最终身高（已知时）低于最初预测值，或治疗后预测身高显著降低。骨龄大于12.0岁与过度骨成熟无关。总之，身高增长速度低于7厘米/年的青春期前儿童从HCG治疗中获益最大，但如果初始骨龄小于12岁，最终身高可能会受到影响。
