Borges Maria de Fátima, Franciscon Priscila de Melo, Cambraia Thamy Contursi, Oliveira Débora Matias, Ferreira Beatriz Pires, Resende Elisabete Aparecida Mantovani Rodrigues de, Palhares Heloísa Marcelina Cunha
Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
Arch Endocrinol Metab. 2015 Dec;59(6):515-22. doi: 10.1590/2359-3997000000101. Epub 2015 Sep 25.
To report our experience of treating central precocious puberty (CPP) with a GnRH analogue with respect to the final heights (FH) attained in patients who completed treatment.
Among 105 records of children diagnosed with precocious puberty, 62 cases (54 girls and 8 boys), who were treated with leuprolide acetate/3.75 mg/monthly, were selected, and divided into 4 groups: group 1 (G1), 25 girls who attained FH; group 2 (G2), 18 girls who completed treatment but did not reach FH; group 3 (G3), 11 girls still under treatment; and group 4 (G4), 8 boys, 5 of which attained FH. Treatment was concluded at a bone age of 12 years, and follow-up continued until FH was achieved.
In both G1 and G2 groups, height standard deviation score (SDS), weight-SDS and percentile of body mass index (PBMI) did not show intra/intergroup differences at the beginning and at interruption of treatment, but when added, G1+G2, height-SDS and weight-SDS differed significantly (p = 0.002 and 0.0001, respectively). In G1, 19 of 25 cases attained TH, and average height gain was 16.7 cm (7.7- 27.1); there was significant difference between FH and prediction of FH at the start (PFH at start) (p = 0.0001), as well as between PFH at interruption vs TH and vs FH (p = 0.007) with FH higher than TH (p = 0.004). Significant correlation was identified between FH and height gain after treatment.
As shown by some studies, GnRH analogue treatment was effective in children with CPP reaching FH near the genetic target.
报告我们使用促性腺激素释放激素(GnRH)类似物治疗中枢性性早熟(CPP)的经验,涉及完成治疗患者所达到的最终身高(FH)。
在105例诊断为性早熟的儿童记录中,选取62例(54例女孩和8例男孩)接受醋酸亮丙瑞林/3.75毫克/月治疗的患者,并分为4组:第1组(G1),25例达到FH的女孩;第2组(G2),18例完成治疗但未达到FH的女孩;第3组(G3),11例仍在接受治疗的女孩;第4组(G4),8例男孩,其中5例达到FH。治疗在骨龄12岁时结束,随访持续至达到FH。
在G1组和G2组中,身高标准差评分(SDS)、体重-SDS和体重指数百分位数(PBMI)在治疗开始和中断时组内/组间均无差异,但G1+G2组相加后,身高-SDS和体重-SDS有显著差异(分别为p = 0.002和0.0001)。在G1组中,25例中有19例达到成年终身高(TH),平均身高增长16.7厘米(7.7 - 27.1);成年终身高(FH)与开始时预测的成年终身高(开始时PFH)之间有显著差异(p = 0.0001),中断时PFH与TH以及与FH之间也有显著差异(p = 0.007),FH高于TH(p = 0.004)。治疗后成年终身高(FH)与身高增长之间存在显著相关性。
如一些研究所示,GnRH类似物治疗对CPP儿童达到接近遗传目标的成年终身高有效。