脉冲式 GnRH 比 hCG 在治疗青春期低促性腺激素性性腺功能减退症男孩方面更有效。
Pulsatile GnRH Is Superior to hCG in Therapeutic Efficacy in Adolescent Boys With Hypogonadotropic Hypogonadodism.
机构信息
Departments of Endocrinology (C.G., M.Q., D.W.) and Pharmacy (Y.L., X.W.), Capital Medical University Affiliated Beijing Children Hospital, Beijing 100045, People's Republic of China.
出版信息
J Clin Endocrinol Metab. 2015 Jul;100(7):2793-9. doi: 10.1210/jc.2015-1343. Epub 2015 May 15.
CONTEXT
We investigated the efficacy and safety of two different treatments that have not been evaluated in peripuberty boys with hypogonadotropic hypogonadism (HH).
OBJECTIVE
The objective of the study was to assess the effectiveness and safety of GnRH or human chorionic gonadotropin (hCG) treatment in adolescent boys with HH.
DESIGN
Twelve patients received 8-10 μg of GnRH, sc injected every 90 minutes using a pump. Another 22 patients received hCG, injected im as follows: for the first 3 months, 1000 IU of hCG was injected two times per week and then once every other day for the next 3 months. The dose of hCG was increased to 2000 IU after a 6-month treatment and the above cycle was repeated for another 6 months. All patients were treated for 12-14 months and followed up every 3 months.
SETTING
Thirty-five participants were chosen from Beijing Children's Hospital from 2008 to 2014. Twenty-three patients with Kallmann syndrome and 12 with normosmic idiopathic hypogonadotropic hypogonadism. The age ranged from 10 to 16 years.
INTERVENTION(S): Twelve patients were treated with pulsatile pump GnRH (group 1), and 22 patients were treated with im hCG (group 2). One patient was treated successively with hCG and GnRH, which was removed in data analysis.
MAIN OUTCOME MEASURE(S): Testicular volume was measured by an orchidometer. The levels of T, LH, and FSH serum were measured with a chemiluminesent immunoassay. Bone age was measured by x-ray.
RESULTS
Patients treated with GnRH showed larger testes than those treated with hCG. Patients in both groups showed a significantly increased length of penis and T levels. But the difference of the two groups was not statistically significant. There was no significant difference in side effects in both groups.
CONCLUSIONS
Boys with HH may be effectively treated with GnRH. We suggested that GnRH exhibits higher efficacy in treating adolescent boys with HH than hCG.
背景
我们研究了两种尚未在青春期前的低促性腺激素性性腺功能减退症（HH）男孩中进行评估的治疗方法的疗效和安全性。
目的
本研究旨在评估 GnRH 或人绒毛膜促性腺激素（hCG）治疗青春期 HH 男孩的有效性和安全性。
设计
12 名患者接受了 8-10μg GnRH，使用泵皮下注射，每 90 分钟注射一次。另外 22 名患者接受了 hCG 肌内注射，如下所示：前 3 个月，每周注射 2 次 1000IU hCG，然后再每隔一天注射一次，接下来 3 个月。治疗 6 个月后，hCG 剂量增加至 2000IU，然后重复上述周期 6 个月。所有患者接受治疗 12-14 个月，每 3 个月随访一次。
地点
2008 年至 2014 年，从北京儿童医院选择了 35 名参与者。23 名 Kallmann 综合征患者和 12 名正常嗅觉特发性低促性腺激素性性腺功能减退症患者。年龄在 10 至 16 岁之间。
干预措施
12 名患者接受脉冲泵 GnRH 治疗（第 1 组），22 名患者接受 hCG 肌内注射治疗（第 2 组）。1 名患者先后接受 hCG 和 GnRH 治疗，该患者在数据分析中被排除。
主要观察指标
睾丸体积通过睾丸测量计测量。血清 T、LH 和 FSH 水平用化学发光免疫分析法测量。骨龄通过 X 射线测量。
结果
接受 GnRH 治疗的患者的睾丸大于接受 hCG 治疗的患者。两组患者的阴茎长度和 T 水平均显著增加。但两组之间的差异无统计学意义。两组的副作用无显著差异。
结论
HH 男孩可以通过 GnRH 有效治疗。我们建议 GnRH 在治疗青春期 HH 男孩方面比 hCG 更有效。
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