Hümmelink R, Oostdijk W, Partsch C J, Odink R J, Drop S L, Sippell W G
Dept. of Paediatrics, Universität Kiel, Germany.
Cesk Pediatr. 1994;49(1):7-12.
More than 100 patients with central precocious puberty are participating in this international multicenter study using monthly i.m. injections of the slow-release GnRH agonist Decapeptyl-Depot. In 15 patients, Decapeptyl-Depot treatment could be discontinued after 2 years of therapy. Gonadal suppression was promptly reversible in all of them, as shown by prepubertal low gonadotrophin and sex steroid levels. Of the remaining 90 patients, 40 have been treated for more than 3 years, including 33 girls and 7 boys. Plasma levels of LH, FSH, estradiol and testosterone dropped to the prepubertal range after one month of Decapeptyl-Depot and remained there for the whole period of therapy. At start of therapy, mean chronologic age of these 40 children was 6.6 +/- 1.4 (SD) years, mean bone age 10.2 +/- 1.9 years. Mean predicted adult height increased in the boys from 173.6 +/- 13.8 (SD) cm at start of therapy to 184.6 +/- 17.0 cm after 3 years. Predicted adult height increased in girls from 158.0 +/- 12.2 to 161.0 +/- 7.5 cm. Undue side effects were not seen, long term tolerance was good. It is concluded that Decapeptyl-Depot injected i.m. every 4 weeks suppresses the pituitary gonadal axis in children with central precocious puberty without clinical or biochemical escapes, and leads to an increase in predicted adult height by more than 3 cm in all boys and in 53% of the girls after three years of treatment.
100多名中枢性性早熟患者正在参与这项国际多中心研究,该研究使用每月一次肌肉注射缓释促性腺激素释放激素激动剂曲普瑞林长效注射剂。15名患者在接受2年治疗后可以停止使用曲普瑞林长效注射剂治疗。所有患者的性腺抑制均可迅速逆转,青春期前低促性腺激素和性类固醇水平表明了这一点。其余90名患者中,40名已接受治疗超过3年,其中包括33名女孩和7名男孩。注射曲普瑞林长效注射剂1个月后,促黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇和睾酮的血浆水平降至青春期前范围,并在整个治疗期间维持在该水平。在治疗开始时,这40名儿童的平均实际年龄为6.6±1.4(标准差)岁,平均骨龄为10.2±1.9岁。男孩的平均预测成年身高从治疗开始时的173.6±13.8(标准差)厘米增加到3年后的184.6±17.0厘米。女孩的预测成年身高从158.0±12.2厘米增加到161.0±7.5厘米。未观察到不当副作用,长期耐受性良好。结论是,每4周肌肉注射一次曲普瑞林长效注射剂可抑制中枢性性早熟儿童的垂体性腺轴,无临床或生化逃逸现象,并且在治疗三年后,所有男孩和53%的女孩的预测成年身高增加超过3厘米。