Schwarz H P, Joss E E, Zuppinger K A
J Clin Endocrinol Metab. 1987 Jul;65(1):136-40. doi: 10.1210/jcem-65-1-136.
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.
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。