Kauli R, Galatzer A, Kornreich L, Lazar L, Pertzelan A, Laron Z
Institute of Pediatric and Adolescent Endocrinology, Schneider Children's Medical Center of Israel, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.
Horm Res. 1997;47(2):54-61. doi: 10.1159/000185432.
This study was designed to determine the benefit of therapy on final height (FHt) in girls with central precocious puberty (CPP). A total of 102 patients were evaluated--28 untreated, 26 treated with cyproterone acetate (CyA), and 48 treated with GnRH analogue (GnRHA)-and their achieved FHt was compared to the respective target height (THt). Of the untreated girls, half (14/28) had a slow course of puberty and reached THt +/- 0.5 SD (FHt 160.2 +/- 7.1, THt 159.5 +/- 6.6 cm); the other half (14/28) had an accelerated course of puberty with a FHt well below THt (FHt 150.8 +/- 4.3, THt, 159.2 +/- 5.9 cm) and in most cases (14/28) below the height-SDS of both parents. The treated girls (both regimens) reached THt above (CyA group: FHt 157.8 +/- 5.1, THt 156.8 +/- 5.1 cm; GnRHA group: 159.6 +/- 6.3, THt 157.7 +/- 5.7 cm). We conclude that without treatment the FHt of girls with CPP may be significantly compromised and that therapy is more beneficial if started before bone age exceeds 12 years. Our data also showed that for final height predictions in CPP the Bayley and Pinneau tables for average children should be used, regardless of the advanced bone age of the patients.
本研究旨在确定治疗对中枢性性早熟（CPP）女孩最终身高（FHt）的益处。共评估了102例患者——28例未治疗，26例用醋酸环丙孕酮（CyA）治疗，48例用促性腺激素释放激素类似物（GnRHA）治疗——并将她们达到的最终身高与各自的靶身高（THt）进行比较。在未治疗的女孩中，一半（14/28）青春期进程缓慢，达到靶身高±0.5标准差（FHt 160.2±7.1，THt 159.5±6.6厘米）；另一半（14/28）青春期进程加速，最终身高远低于靶身高（FHt 150.8±4.3，THt 159.2±5.9厘米），且在大多数情况下（14/28）低于父母双方的身高标准差。接受治疗的女孩（两种治疗方案）达到的最终身高均高于靶身高（CyA组：FHt 157.8±5.1，THt 156.8±5.1厘米；GnRHA组：159.6±6.3，THt 157.7±5.7厘米）。我们得出结论，未经治疗的CPP女孩的最终身高可能会受到显著影响，且如果在骨龄超过12岁之前开始治疗则更有益。我们的数据还表明，对于CPP患者的最终身高预测，应使用针对普通儿童的贝利和皮诺表，而不考虑患者提前的骨龄。
