[中枢性性早熟女童垂体-性腺轴完全抑制与不完全抑制的比较：对生长及预期终身高的影响]

[Comparison between complete and incomplete suppression of the hypophyseal-gonadal axis in girls with central precocious puberty: effect on growth and prospective final height].

作者信息

Partsch C J, Hümmelink R, Sippell W G, Oostdijk W, Odink R J, Drop S L

机构信息

Universitäts-Kinderkliniken, Kiel.

出版信息

Monatsschr Kinderheilkd. 1993 Dec;141(12):935-9.

PMID:8114776

Abstract

BACKGROUND

Whether short-acting or slow-release gonadotropin-releasing hormone agonists have different effects on growth and bone maturation in children with central precocious puberty is still unknown.

METHODS

In a meta-analysis, we studied 21 previously untreated girls with central precocious puberty treated with Buserelin and 22 previously untreated girls with central precocious puberty treated with Decapeptyl Depot. Duration of treatment was at least 18 months in both groups.

RESULTS

At start of therapy, chronological age, bone age, height velocity and pubertal stage were well comparable between the groups. During the first 6 months of treatment, clinical and biochemical escapes from suppression were more frequent in the Buserelin group; height velocity and bone maturation (delta bone age/delta chronological age) remained significantly higher (p < 0.0001 and p < 0.01, resp.) in Buserelin than in Decapeptyl Depot patients. In contrast to the Decapeptyl Depot group, in the Buserelin patients height standard deviation score for bone age did not change and predicted adult height decreased. From 6 to 18 months of therapy, the development of height velocity, delta bone age/delta chronological age, standard deviation score for bone age and predicted adult height showed an almost parallel course in both groups. Height velocity and bone maturation tended to be faster in the Buserelin group. Mean predicted adult height rose significantly in the Decapeptyl Depot group, but not in the Buserelin-treated girls.

CONCLUSIONS

A slow-release gonadotropin-releasing hormone agonist appears to be superior to short-acting drugs not only in terms of long-term tolerance but also for achieving the auxological objectives in central precocious puberty therapy. This is mainly due to their faster and more complete suppression of gonadotropins during the first 6 months of treatment.

摘要

背景

短效或缓释促性腺激素释放激素激动剂对中枢性性早熟儿童的生长和骨骼成熟是否有不同影响尚不清楚。

方法

在一项荟萃分析中，我们研究了21名先前未接受治疗、使用布舍瑞林治疗的中枢性性早熟女孩，以及22名先前未接受治疗、使用曲普瑞林长效注射剂治疗的中枢性性早熟女孩。两组的治疗时间均至少为18个月。

结果

治疗开始时，两组的实际年龄、骨龄、身高增长速度和青春期阶段具有良好的可比性。在治疗的前6个月，布舍瑞林组临床和生化抑制解除更为频繁；布舍瑞林组的身高增长速度和骨骼成熟度（骨龄变化/实际年龄变化）显著高于曲普瑞林长效注射剂组（分别为p<0.0001和p<0.01）。与曲普瑞林长效注射剂组不同，布舍瑞林组患者骨龄的身高标准差评分没有变化，预测成年身高降低。在治疗6至18个月期间，两组身高增长速度、骨龄变化/实际年龄变化、骨龄标准差评分和预测成年身高的发展显示出几乎平行的过程。布舍瑞林组的身高增长速度和骨骼成熟度往往更快。曲普瑞林长效注射剂组的平均预测成年身高显著上升，但布舍瑞林治疗的女孩则没有。