Stanhope R, Brook C G, Pringle P J, Adams J, Jacobs H S
Lancet. 1987 Sep 5;2(8558):552-5. doi: 10.1016/s0140-6736(87)92932-1.
15 girls and 17 boys with delayed or arrested puberty were treated with gonadotropin releasing hormone (GnRH) for a mean of 1.04 years. GnRH was administered subcutaneously in a pulsatile fashion at 90 min intervals, and the dose was increased as required to maintain progression of puberty, initially only at night and subsequently over 24 h. Initial GnRH dose was 1-2 micrograms per pulse in the girls and 2-4 micrograms per pulse in the boys. The effect of treatment was monitored by serial overnight gonadotropin profiles in all patients and with pelvic ultrasound in the girls. The clinical features, growth acceleration, endocrinology, and ovarian ultrasound morphology of puberty were those seen in normal children. Measurement of spontaneous gonadotropin pulsatility after treatment had been discontinued allowed the distinction between 20 patients with hypogonadotropic hypogonadism and 12 who had constitutional delay of growth and puberty. 2 girls and 6 boys did not respond to the treatment regimen. These findings indicate that normal puberty is GnRH dependent.
15名青春期延迟或停滞的女孩和17名男孩接受了促性腺激素释放激素（GnRH）治疗，平均治疗时间为1.04年。GnRH以脉冲式皮下注射，间隔90分钟一次，剂量根据维持青春期进展的需要增加，最初仅在夜间给药，随后改为24小时给药。女孩的初始GnRH剂量为每脉冲1 - 2微克，男孩为每脉冲2 - 4微克。所有患者均通过连续的夜间促性腺激素水平监测治疗效果，女孩还进行盆腔超声检查。青春期的临床特征、生长加速、内分泌学以及卵巢超声形态与正常儿童相似。在治疗停止后测量自发性促性腺激素脉冲性，可区分出20例低促性腺激素性性腺功能减退患者和12例体质性生长和青春期延迟患者。2名女孩和6名男孩对治疗方案无反应。这些发现表明正常青春期依赖GnRH。
