Saggese G, Pasquino A M, Bertelloni S, Baroncelli G I, Battini R, Pucarelli I, Segni M, Franchi G
Department of Pediatrics, University of Pisa, Italy.
Acta Paediatr. 1995 Mar;84(3):299-304. doi: 10.1111/j.1651-2227.1995.tb13632.x.
Growth hormone-insulin-like growth factor-I status and response to growth hormone therapy (0.6 IU/kg/week sc, six times a week for 12 months) were evaluated in 12 girls (chronological age 9.4 +/- 1.6 years) suffering from central precocious puberty with growth velocity less than 4 cm/year and no substantial increase or decrease in predicted adult height during gonadotropin releasing hormone Bn-RH) analogue treatment (D-Trp6-LH-RH, 60 micrograms/kg im/28 days). At baseline, large variations were observed in nocturnal growth hormone (GH) means (pathological values stimulated levodopa GH peaks (pathological values (< 10.0 micrograms/l) 28.6%) and serum insulin-like growth factor-I (IGF-I) levels. Neither GH-nor IGF-I levels were correlated with growth velocity. During recombinant GH therapy, growth velocity increased significantly (baseline 3.0 +/- 0.9 cm/year; 6 months 6.4 +/- 1.9 cm/year, p < 0.001 versus baseline; 12 months 6.0 +/- 1.3 cm/year, p < 0.0001 versus baseline). There was a significant increase in height SDS for bone age (baseline -1.6 +/- 0.5 SDS; 12 months -1.04 +/- 0.6 SDS; p < 0.002) and in predicted adult height (baseline 152.0 +/- 3.6 cm; 12 months 155.9 +/- 3.4 cm; p < 0.002). Our results suggest that combined therapy with Gn-RH analogues and recombinant GH can improve growth velocity and predicted adult height in girls with central precocious puberty and impaired height prognosis during Gn-RH analogue treatment.
对12名患有中枢性性早熟的女孩（实际年龄9.4±1.6岁）进行了生长激素-胰岛素样生长因子-I状态及生长激素治疗反应（0.6 IU/kg/周皮下注射，每周6次，共12个月）的评估，这些女孩生长速度低于4厘米/年，且在促性腺激素释放激素（Gn-RH）类似物治疗（D-色氨酸6-促黄体生成素释放激素，60微克/千克肌肉注射/28天）期间预测成年身高无显著增加或减少。基线时，观察到夜间生长激素（GH）均值存在较大差异（病理值刺激左旋多巴GH峰值（病理值（<10.0微克/升）28.6%）以及血清胰岛素样生长因子-I（IGF-I）水平。GH水平和IGF-I水平均与生长速度无关。在重组GH治疗期间，生长速度显著增加（基线3.0±0.9厘米/年；6个月时6.4±1.9厘米/年，与基线相比p<0.001；12个月时6.0±1.3厘米/年，与基线相比p<0.0001）。骨龄身高标准差有显著增加（基线-1.6±0.5标准差；12个月时-1.04±0.6标准差；p<0.002），预测成年身高也有显著增加（基线152.0±3.6厘米；12个月时155.9±3.4厘米；p<0.002）。我们的结果表明，Gn-RH类似物与重组GH联合治疗可改善中枢性性早熟且在Gn-RH类似物治疗期间身高预后受损的女孩的生长速度和预测成年身高。
