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韩国中枢性性早熟女孩单独使用促性腺激素释放激素激动剂或联合生长激素治疗后的初潮年龄及接近最终身高情况。

Age at menarche and near final height after treatment with gonadotropin-releasing hormone agonist alone or combined with growth hormone in Korean girls with central precocious puberty.

作者信息

Gyon YunHee, Yun Yeong Ju, Kim Yong-Dae, Han Heon-Seok

机构信息

Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

Department of Preventive Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

出版信息

Clin Pediatr Endocrinol. 2015 Oct;24(4):175-83. doi: 10.1297/cpe.24.175. Epub 2015 Oct 24.

Abstract

The use of a GnRH agonist (GnRHa) in central precocious puberty (CPP) is known to slow puberty progression, subsequently prevent early menarche, and attenuate the height loss caused by advanced skeletal maturation. But enhancing the final height has been so controversial that an additional approach has been used. We investigated the menarcheal age and near final height (NFH) in girls with CPP treated with GnRHa (N = 61) or GnRHa combined GH (N = 24). GnRHa was started at 8.1 ± 0.7 yr and administered for 2.1 ± 1.0 years. GH was used for 2.1 ± 1.1 yr in subjects with a short predicted adult height (PAH). Menarche occurred at 11.6 ± 0.8 yr of age, which was 15.7 ± 6.4 mo after GnRHa discontinuation. PAH increased significantly from 152.0 ± 7.2 cm to 158.8 ± 5.6 cm during treatment, and the NFH (159.7 ± 4.8 cm) was taller than the midparental height (157.8 ± 3.4 cm). The combined treatment group showed a greater height increment during treatment. Younger age, taller height at the start of treatment, taller parental height and longer duration of treatment were the factors influencing NFH. In conclusion, GnRHa treatment in girls with CPP could improve NFH and delay menarche close to the general population. If GnRHa combined with GH is used in girls with CPP and a short midparental height, it would improve the NFH to a value similar to that in the general population.

摘要

已知在中枢性性早熟(CPP)中使用促性腺激素释放激素激动剂(GnRHa)可减缓青春期进程,随后预防初潮过早,并减轻骨骼成熟提前导致的身高损失。但提高最终身高一直存在争议,因此采用了另一种方法。我们调查了接受GnRHa治疗(N = 61)或GnRHa联合生长激素(GH)治疗(N = 24)的CPP女孩的初潮年龄和接近最终身高(NFH)。GnRHa在8.1±0.7岁开始使用,给药2.1±1.0年。对于预测成年身高(PAH)较短的受试者,GH使用2.1±1.1年。初潮发生在11.6±0.8岁,即在停用GnRHa后15.7±6.4个月。治疗期间PAH从152.0±7.2厘米显著增加到158.8±5.6厘米,NFH(159.7±4.8厘米)高于父母平均身高(157.8±3.4厘米)。联合治疗组在治疗期间身高增长更大。年龄较小、治疗开始时身高较高、父母身高较高以及治疗持续时间较长是影响NFH的因素。总之,对CPP女孩进行GnRHa治疗可改善NFH并使初潮延迟至接近一般人群的水平。如果对CPP且父母平均身高较短的女孩使用GnRHa联合GH,将使NFH提高到与一般人群相似的值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f8/4628952/31cedc7369e6/cpe-24-175-g001.jpg

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