促性腺激素释放激素治疗改善特发性中枢性性早熟男孩的成年身高

Final height outcome of boys with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogue

目的观察缓释型促性腺激素释放激素类似物（GnRHa）治疗后的特发性中枢性性早熟（ICPP）男孩的成年身高。方法20例ICPP男孩接受GnRHa治疗（20．0±6．1）个月，治疗开始时的年龄和骨龄分别为（11．4±1．0）和（13．0±0．4）岁，当年龄和骨龄达（13．2±1．1）和（13．7±0．6）岁时停止治疗．治疗结束后经随诊（3．3±1．5）年，均已达接近成年身高（FAH）。比较预测成年身高（PAH）、FAH和遗传靶身高（THt），探讨GnRHa治疗ICPP男孩对于改善成年身高的远期疗效。结果成年身高均达遗传靶身高范围，FAH与THt的差异无统计学意义[（169．8±5．8对167．8±4．6）cm，P〉0．05]。按骨龄身高SDS预测成年身高（生长曲线法），GnRHa治疗后的PAH较治疗前显著改善[（169．0±5．0对166．2±4．2）cm，P〈0．01]；治疗结束时的PAH、FAH和THt差异无统计学意义（P〉0．05）；身高净获为（3．62±3．57）cm；剩余生长能力为（11．82±3．99）cm。结论GnRHa能改善ICPP男孩的成年身高。

Objective To observe the final adult height of 20 boys with idiopathic central precocious puberty （ICPP） treated with slow-releasing gonadotropin-releasing hormone analogue（GnRHa）. Methods Twenty boys with ICPP were treated with GnRHa for（20.0 ± 6. 1 ） months. At the beginning of therapy, mean chronological age and bone age was（ 11.4 ± 1.0 ） years and （ 13.0 ±0.4 ） years, respectively. GnRHa was discontinued when the boys reached the chronological age and bone age of（ 13.2 ± 1.1 ） years and（ 13.7 ± 0.6） years, respectively. After the end of treatment, all the boys had been followed up for（ 3.3 ±1.5 ） years and had achieved adult height. Comparisons were made among their predicted adult height （ PAH ）, final adult height （ FAH ）, and target height （THt）. The long-term outcome of final adult height in boys with ICPP was investigated after GnRHa treatment. Results All the boys reached target height range. Final height was similar to the target height [ （ 169.8 ± 5.8 vs 167.8 ± 4.6 ） era, P〉 0.051 - The height gain, defined as the difference between predicted adult height at the start of treatment using the height SDS for bone age and actual adult height was（ 3.62 ±3.57 ） cm with the residual growth capacity of （ 11.82 ± 3.99）cm. PAH significantly improved after GnRHa treatment compared with before treatment [ （ 169.0 ±5.0 vs 166.2 ± 4. 2） em, P〈 0.01 1. There were no differences among PAH, FAH, and THt. Conclusion GnRHa treatment improves final height within the range of target height in boys with central precocious puberty.