Brämswig J H, von Lengerke H J, Schmidt H, Schellong G
Kinderklinik der Universität, Münster, Federal Republic of Germany.
Eur J Pediatr. 1988 Nov;148(2):104-6. doi: 10.1007/BF00445913.
Forty-nine pubertal tall boys with a mean height prediction of 203.59 cm according to the Bayley-Pinneau (BP) method were treated prospectively with 500 mg testosterone-oenanthate every 2 weeks for a period of 6 months. Before therapy chronological age (CA) was 14.14 years and bone age (BA) 13.88 years using the Greulich-Pyle (GP) method. During therapy BA advanced by 1.37 years. It continued to accelerate during the 6 months following therapy with a mean delta BA/delta CA being 3.01 at 3 months and 2.24 at 6 months after therapy. The 6 months value was only slightly less than the delta BA/delta CA of 2.47 obtained during therapy. The reduction in adult height was 7.26 cm or 50.8% of the predicted further growth in 12 boys with a long-term follow up of 2.5 years. This is similar to the 51.6% or 9.63 cm observed in 50 boys with a long-term follow up after 14.25 month treatment until a BA of 17 years or more. It is concluded that in the majority of cases high-dose testosterone therapy in boys of tall stature can be limited to a 6-month treatment period. Reassessment of the height prediction after a 6-month interval without therapy should define those patients who have to resume treatment because of their remaining excessive growth potential.
49名青春期高个男孩,根据贝利-平诺(BP)方法预测平均身高为203.59厘米,前瞻性地接受每2周500毫克庚酸睾酮治疗,为期6个月。治疗前,根据格吕利希-派尔(GP)方法,实际年龄(CA)为14.14岁,骨龄(BA)为13.88岁。治疗期间,骨龄进展了1.37岁。在治疗后的6个月内仍继续加速,治疗后3个月时平均骨龄变化/实际年龄变化为3.01,6个月时为2.24。6个月时的值仅略低于治疗期间获得的骨龄变化/实际年龄变化2.47。在对12名男孩进行2.5年的长期随访中,成年身高降低了7.26厘米,占预测进一步生长的50.8%。这与在50名男孩中观察到的51.6%或9.63厘米相似,这些男孩在接受14.25个月治疗直至骨龄达到17岁或更大后进行了长期随访。结论是,在大多数情况下,高剂量睾酮治疗高个男孩可限于6个月的治疗期。在6个月不治疗的间隔后重新评估身高预测,应确定那些因仍有过度生长潜力而必须恢复治疗的患者。