Oostdijk W, Rikken B, Schreuder S, Otten B, Odink R, Rouwé C, Jansen M, Gerver W J, Waelkens J, Drop S
Department of Paediatrics, Leiden University, Netherlands.
Arch Dis Child. 1996 Oct;75(4):292-7. doi: 10.1136/adc.75.4.292.
To study the resumption of puberty and the final height achieved in children with central precocious puberty (CPP) treated with the GnRH agonist triptorelin.
31 girls and five boys with CPP who were treated with triptorelin 3.75 mg intramuscularly every four weeks. Girls were treated for a mean (SD) of 3.4 (1.0) years and were followed up for 4.0 (1.2) years after the treatment was stopped.
The rate of bone maturation decreased during treatment and the predicted adult height increased from 158.2 (7.4) cm to 163.9 (7.5) cm at the end of treatment (p < 0.001). When treatment was stopped bone maturation accelerated, resulting in a final height of 161.6 (7.0) cm, which was higher than the predicted adult height at the start of treatment (p < 0.001). Height at the start of treatment was the most important factor positively influencing final height (r = 0.75, p < 0.001). Bone age at cessation of treatment negatively influenced final height (r = -0.52, p = 0.03). A negative correlation between bone age and height increment after discontinuation of treatment was observed (r = -0.85, p = 0.001). Residual growth capacity was optimal when bone age on cessation of treatment was 12 to 12.5 years. Body mass index increased during treatment and remained high on cessation. At final height, the ratio of sitting height to subischial leg length was normal. Menarche occurred at 12.3 (1.1) years, and at a median (range) of 1.1 (0.4 to 2.6) years after treatment was stopped. The ovaries were normal on pelvic ultrasonography.
Treatment of CPP with triptorelin increases final height, with normal body proportions, and seems to increase body mass index. The best results were achieved in girls who were taller at the start of treatment. Puberty was resumed after treatment, without the occurrence of polycystic ovaries.
研究用促性腺激素释放激素（GnRH）激动剂曲普瑞林治疗的中枢性性早熟（CPP）儿童青春期的恢复情况及最终身高。
31名女孩和5名男孩患有CPP，每四周接受一次3.75mg曲普瑞林肌肉注射治疗。女孩治疗的平均（标准差）时间为3.4（1.0）年，治疗停止后随访4.0（1.2）年。
治疗期间骨成熟率下降，治疗结束时预测成人身高从158.2（7.4）cm增加到163.9（7.5）cm（p<0.001）。治疗停止后骨成熟加速，最终身高为161.6（7.0）cm，高于治疗开始时的预测成人身高（p<0.001）。治疗开始时的身高是对最终身高有积极影响的最重要因素（r=0.75，p<0.001）。治疗停止时的骨龄对最终身高有负面影响（r=-0.52，p=0.03）。观察到治疗停止后骨龄与身高增长之间呈负相关（r=-0.85，p=0.001）。当治疗停止时骨龄为12至12.5岁时，剩余生长能力最佳。治疗期间体重指数增加，停止治疗后仍保持较高水平。在最终身高时，坐高与坐骨下腿长的比值正常。月经初潮发生在12.3（1.1）岁，治疗停止后的中位（范围）时间为1.1（0.4至2.6）年。盆腔超声检查显示卵巢正常。
用曲普瑞林治疗CPP可增加最终身高，身体比例正常，且似乎会增加体重指数。治疗开始时较高的女孩取得了最佳效果。治疗后青春期恢复，未出现多囊卵巢。
