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甲硫氨酰人生长激素与氧雄龙治疗特纳综合征:一项前瞻性随机试验的初步结果

Methionyl human growth hormone and oxandrolone in Turner syndrome: preliminary results of a prospective randomized trial.

作者信息

Rosenfeld R G, Hintz R L, Johanson A J, Brasel J A, Burstein S, Chernausek S D, Clabots T, Frane J, Gotlin R W, Kuntze J

出版信息

J Pediatr. 1986 Dec;109(6):936-43. doi: 10.1016/s0022-3476(86)80272-4.

Abstract

Seventy girls with Turner syndrome, 4 to 12 years of age, were randomly assigned to receive either no treatment (control) or methionyl human growth hormone (0.125 mg/kg three times per week), oxandrolone (0.125 mg/kg/day), or combination hGH plus oxandrolone therapy. Baseline growth rates averaged 4.3 cm/yr, and all were within 2 SD of mean growth velocity for age in girls with Turner syndrome. Sixty-seven girls remained in the study for a minimum of 1 year. Growth rates and growth velocity (in standard deviations for age in girls with Turner syndrome) were control 3.8 cm/yr (-0.1 SD), hGH 6.6 cm/yr (+2.3 SD), oxandrolone 7.9 cm/yr (+3.7 SD), and combination therapy 9.8 cm/yr (+5.4 SD). Mean bone ages advanced 1.0 years (hGH), 1.3 years (oxandrolone), and 1.6 years (combination). However, median increments in height age/bone age (delta HA/delta BA) ratios ranged from 1.0 to 1.1 for treatment groups, compared with 0.8 for the controls. Predicted adult height by the method of Bayley-Pinneau increased 2.5 cm for hGH or oxandrolone alone, and 3.2 cm for combination treatment. These data indicate that both hGH and oxandrolone can significantly stimulate short-term skeletal growth in patients with Turner syndrome, and potentially increase final adult height.

摘要

70名4至12岁的特纳综合征女孩被随机分配接受无治疗(对照组)或甲硫氨酰人生长激素(0.125毫克/千克,每周三次)、氧雄龙(0.125毫克/千克/天)或生长激素加氧雄龙联合治疗。基线生长速率平均为4.3厘米/年,且所有数据均在特纳综合征女孩年龄平均生长速度的2个标准差范围内。67名女孩至少参与研究1年。生长速率和生长速度(以特纳综合征女孩年龄的标准差表示)分别为:对照组3.8厘米/年(-0.1标准差),生长激素组6.6厘米/年(+2.3标准差),氧雄龙组7.9厘米/年(+3.7标准差),联合治疗组9.8厘米/年(+5.4标准差)。平均骨龄增长分别为:生长激素组1.0岁,氧雄龙组1.3岁,联合治疗组1.6岁。然而,治疗组身高年龄/骨龄(ΔHA/ΔBA)比值的中位数增量在1.0至1.1之间,而对照组为0.8。采用贝利 - 平诺方法预测的成人身高,生长激素或氧雄龙单独治疗增加2.5厘米,联合治疗增加3.2厘米。这些数据表明,生长激素和氧雄龙均可显著刺激特纳综合征患者的短期骨骼生长,并可能增加最终成人身高。

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