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溴隐亭治疗家族性身材高大的青春期男孩:一项配对对照研究。

Bromocriptine treatment in adolescent boys with familial tall stature: a pair-matched controlled study.

作者信息

Schwarz H P, Joss E E, Zuppinger K A

出版信息

J Clin Endocrinol Metab. 1987 Jul;65(1):136-40. doi: 10.1210/jcem-65-1-136.

Abstract

Recently, bromocriptine has been proposed as a novel agent for the treatment of excessively tall stature in adolescents. To further test its value, we treated nine boys, aged 10.0-15.4 yr, for 1 yr with bromocriptine (7.5 mg/day). A paradoxical plasma GH response to TRH was demonstrated in four of eight boys before and in five boys after 6 months of bromocriptine treatment. At the onset of therapy, the mean adult height prediction was 202.2 +/- 4.3 (+/- SD) cm (Bayley-Pinneau), 202.1 +/- 4.7 cm (TW Mark II), and 198.6 +/- 5.3 cm (Roche-Wainer-Thissen). After 1 yr of therapy, the mean adult height prediction had changed by -4.5 +/- 2.6 cm (Bayley-Pinneau), -3.4 +/- 2.2 cm (TW Mark II), and -2.6 +/- 1.2 cm (Roche-Wainer-Thissen). These reductions were solely due to a decrease in growth velocity and not to an increased skeletal maturation rate. To substantiate these findings, each treated boy was pair-matched with an untreated tall boy so that their chronological and skeletal ages differed by less than 1 yr. After 1 yr of follow-up, height predictions in the treated boys compared with those in the matched control boys gave significantly reduced results with the Bayley-Pinneau and the Roche-Wainer-Thissen, but not with the TW Mark II, method. Because of this discrepancy it is uncertain whether final height in tall boys will really be reduced by treatment with bromocriptine.

摘要

最近,溴隐亭已被提议作为治疗青少年身材过高的一种新型药物。为了进一步检验其价值,我们用溴隐亭(7.5毫克/天)对9名年龄在10.0至15.4岁的男孩进行了1年的治疗。在8名男孩中,有4名在治疗前以及5名在溴隐亭治疗6个月后出现了对促甲状腺激素释放激素(TRH)的反常血浆生长激素(GH)反应。治疗开始时,根据贝利-皮诺(Bayley-Pinneau)法预测的平均成人身高为202.2±4.3(±标准差)厘米,根据TW Mark II法为202.1±4.7厘米,根据罗氏-韦纳-蒂森(Roche-Wainer-Thissen)法为198.6±5.3厘米。治疗1年后,根据贝利-皮诺法预测的平均成人身高变化了-4.5±2.6厘米,根据TW Mark II法变化了-3.4±2.2厘米,根据罗氏-韦纳-蒂森法变化了-2.6±1.2厘米。这些降低完全是由于生长速度的下降,而非骨骼成熟速度的加快。为了证实这些发现,将每个接受治疗的男孩与一个未接受治疗的高个子男孩进行配对,使他们的实际年龄和骨骼年龄相差不到1岁。经过1年的随访,采用贝利-皮诺法和罗氏-韦纳-蒂森法时,接受治疗的男孩与配对的对照男孩相比,身高预测结果显著降低,但采用TW Mark II法时则不然。由于这种差异,尚不确定用溴隐亭治疗是否真的会降低高个子男孩的最终身高。

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