Birnbacher R, Riedl S, Frisch H
Pediatric Department, Endocrinology, University Hospital Vienna, Austria.
Horm Res. 1998;49(2):80-5. doi: 10.1159/000023131.
Auxological data, pubertal development and final height were analyzed in 25 patients with growth hormone (GH) deficiency who were treated only with pituitary GH in 3 doses/week. 15 patients had a spontaneous onset of puberty and in 10 puberty was induced. The duration of therapy was 7.5 years, the dosage was about 11 U/m2/week and was not changed during puberty. 80% of the patients with induced puberty, but only 33% of the children with spontaneous puberty reached final heights within the 2 SD range. Final height was correlated with height at the start of treatment only in patients with spontaneous puberty, which shows the necessity of early treatment initiation in this group. The lack of this correlation in patients with induced puberty might be attributed to gonadotropin deficiency. Height at the onset of puberty was related to final height only in the group with gonadotropin deficiency. A prediction model for calculation of the first year height velocity which was derived from present treatment procedures showed a too favorable prediction for our patients. The reasons for the insufficient final results may be due to impure GH preparations, suboptimal dosage, low frequency of injections and late onset of therapy.
对25例生长激素（GH）缺乏患者的体格发育数据、青春期发育及最终身高进行了分析，这些患者仅接受每周3次垂体GH治疗。15例患者青春期自然启动，10例患者青春期为诱导启动。治疗持续时间为7.5年，剂量约为11U/m²/周，且在青春期未改变。80%的青春期诱导启动患者达到了最终身高，但只有33%的青春期自然启动儿童达到了最终身高在2个标准差范围内。仅在青春期自然启动的患者中，最终身高与治疗开始时的身高相关，这表明该组患者早期开始治疗的必要性。青春期诱导启动患者缺乏这种相关性可能归因于促性腺激素缺乏。仅在促性腺激素缺乏组中，青春期开始时的身高与最终身高相关。根据目前治疗程序推导的计算第一年身高增长速度的预测模型对我们的患者显示出过于乐观的预测。最终结果不理想的原因可能是GH制剂不纯、剂量次优、注射频率低和治疗开始较晚。
