Comite F, Cutler G B, Rivier J, Vale W W, Loriaux D L, Crowley W F
N Engl J Med. 1981 Dec 24;305(26):1546-50. doi: 10.1056/NEJM198112243052602.
The uncoupling of pituitary stimulation and response observed in adults during administration of the luteinizing hormone-releasing hormone analogue, D-Trp6-Pro9-NEt-LHRH (LHRHa) suggested that this drug might be useful in treating precocious puberty. We treated five girls with idiopathic precocious puberty (ages two to eight) for eight weeks with daily subcutaneous injections of LHRHa. The patients had Tanner II to IV pubertal development, advanced bone age, an estrogen effect on vaginal smear, measurable basal gonadotropin levels with pulsed nocturnal secretion, and a pubertal gonadotropin response to LHRH. Irregular vaginal bleeding was present in three patients. LHRHa significantly decreased basal (P less than 0.025) and LHRH-stimulated (P less than 0.01) gonadotropin levels as well as serum estradiol (P less than 0.05). The vaginal maturation-index score, which reflects the estrogen effect, fell by 25 per cent. Eight weeks after stopping treatment, all hormonal values and the vaginal maturation index had returned to pretreatment levels. These favorable short-term results will need further study before the benefits and risks of chronic treatment with LHRHa can be adequately assessed.
在成年人中，使用促黄体生成激素释放激素类似物D-色氨酸6-脯氨酸9-乙基-LHRH（LHRHa）时观察到垂体刺激与反应的解偶联，这表明该药物可能对治疗性早熟有用。我们对5名患有特发性性早熟的女孩（年龄在2至8岁之间）进行了为期8周的治疗，每天皮下注射LHRHa。这些患者有坦纳II至IV期的青春期发育、骨龄提前、阴道涂片有雌激素效应、可测量的基础促性腺激素水平伴有夜间脉冲式分泌，以及对LHRH有青春期促性腺激素反应。3名患者出现不规则阴道出血。LHRHa显著降低了基础促性腺激素水平（P<0.025）和LHRH刺激后的促性腺激素水平（P<0.01）以及血清雌二醇水平（P<0.05）。反映雌激素效应的阴道成熟指数评分下降了25%。停止治疗8周后，所有激素值和阴道成熟指数都恢复到了治疗前水平。在能够充分评估LHRHa长期治疗的益处和风险之前，这些良好的短期结果还需要进一步研究。
