重组人生长激素（rhGH）联合来曲唑/促性腺激素释放激素类似物（GnRHa）治疗青春期男孩的疗效与安全性。
The efficacy and safety of rhGH treatment combined with letrozole/GnRHa in adolescent boys.
作者信息
Zhang Ying, Yuan Xin, McCormick Kenneth, Yang Xiao-Hong, Chen Shi-Jun, Chen Rui-Min
机构信息
Department of Endocrinology, Genetics and Metabolism, Fuzhou First General Hospital Affiliated with Fujian Medical University, Fuzhou Children's Hospital of Fujian Medical University, Fuzhou, 350005, China.
Division of Pediatric Endocrinology and Diabetes, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
出版信息
BMC Pediatr. 2025 Jan 24;25(1):59. doi: 10.1186/s12887-025-05408-y.
OBJECTIVE
In boys during puberty who were undergoing recombinant human growth hormone (rhGH) treatment, we compared the therapeutic efficacy on growth, and any adverse reactions, of co-therapy with either letrozole or gonadotropin-releasing hormone analog (GnRHa).
METHODS
Fifty-six pubertal growth hormone deficiency (GHD) boys were studied, they were treated with the combination of letrozole and rhGH (letrozole group, n = 28) or the combination of GnRHa and rhGH (GnRHa group, n = 28) for at least one year. Eighteen patients in the letrozole group and seventeen patients in the GnRHa group attained final adult height (FAH).
RESULTS
The increase in height of the letrozole group was significantly more than the GnRHa group both in the first year [(10.37 ± 2.19) vs. (7.78 ± 1.55) cm] and at two years [(18.82 ± 2.49) vs. (13.84 ± 2.17) cm] (p < 0.05), however, there was no significant group difference in the advancement of bone age (BA) of in the first year or at two years (p > 0.05). The mean FAH in two groups were similar, but the treatment duration of the letrozole group was significantly less than GnRHa group. There was a significant body mass index (BMI) SDS increase in the letrozole vs. GnRHa groups. Of concern, bone mineral density (BMD) decreased in both groups after treatment, but more so in the letrozole cohort.
CONCLUSION
The combination of letrozole/rhGH in pubertal GHD boys was similar to GnRHa/rhGH in terms of the progression of BA and FAH, but the former co-therapy was superior in the gain of height. Disconcertingly, however, this combination may adversely affect BMI and BMD.
CLINICAL TRIAL REGISTRATION NUMBER
ChiCTR2300068405.
目的
在接受重组人生长激素（rhGH）治疗的青春期男孩中，我们比较了来曲唑或促性腺激素释放激素类似物（GnRHa）联合治疗对生长的疗效及任何不良反应。
方法
研究了56名青春期生长激素缺乏（GHD）男孩，他们接受来曲唑与rhGH联合治疗（来曲唑组，n = 28）或GnRHa与rhGH联合治疗（GnRHa组，n = 28）至少一年。来曲唑组18例患者和GnRHa组17例患者达到最终成人身高（FAH）。
结果
来曲唑组在第一年[（10.37±2.19）对（7.78±1.55）cm]和两年时[（18.82±2.49）对（13.84±2.17）cm]的身高增长均显著高于GnRHa组（p < 0.05），然而，两组在第一年或两年时骨龄（BA）进展方面无显著组间差异（p > 0.05）。两组的平均FAH相似，但来曲唑组的治疗持续时间显著短于GnRHa组。与GnRHa组相比，来曲唑组的体重指数（BMI）标准差得分显著增加。值得关注的是，两组治疗后骨矿物质密度（BMD）均下降，但来曲唑组下降更明显。
结论
青春期GHD男孩中来曲唑/rhGH联合治疗在BA进展和FAH方面与GnRHa/rhGH相似，但前者联合治疗在身高增长方面更优。然而，令人不安的是，这种联合治疗可能对BMI和BMD产生不利影响。
临床试验注册号
ChiCTR2300068405。
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