Background:Compared to adult studies,studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism(CHH)are limited and no universal treatment regimen is available.The aim of this study was ...Background:Compared to adult studies,studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism(CHH)are limited and no universal treatment regimen is available.The aim of this study was to evaluate the feasibility of human chorionic gonadotropin(hCG)/human menopausal gonadotropin(hMG)therapy for treating male adolescents with CHH.Methods:Male adolescent CHH patients were treated with hCG/hMG(n=20)or a gonadotropin-releasing hormone(GnRH)pump(n=21).The treatment was divided into a study phase(0-3 months)and a follow-up phase(3-12 months).The testicular volume(TV),penile length(PL),penis diameter(PD),and sex hormone levels were compared between the two groups.The TV and other indicators between the groups were analyzed using a t-test(equal variance)or a rank sum test(unequal variance).Results:Before treatment,there was no statistical difference between the two groups in terms of the biochemistry,hormones,and other demographic indicators.After 3 months of treatment,the TV of the hCG/hMG and GnRH groups increased to 5.1±2.3 mL and 4.1±1.8 mL,respectively;however,the difference was not statistically significant(P>0.05,t=1.394).The PL reached 6.9±1.8 cm and 5.1±1.6 cm(P<0.05,t=3.083),the PD reached 2.4±0.5 cm and 2.0±0.6 cm(P<0.05,t=2.224),respectively,in the two groups.At the end of 6 months of treatment,biomarkers were in normal range in the two groups.Compared with the GnRH group,the testosterone(T)level and growth of PL and PD were significantly greater in the hCG/hMG group(all P<0.05).While the TV of both groups increased,the difference was not statistically significant(P>0.05,t=0.314).After 9 to 12 months of treatment,the T level was higher in the hCG/hMG group.Other parameters did not exhibit a statistical difference.Conclusions:The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH.The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy.Furthermore,results from the extended time-period showed positive outcomes at the 1-year mark;however,the long-term effectiveness,strengths,and weaknesses of the hCG/hMG regimen require further research.Trial Registration:ClinicalTrials.gov,NCT02880280;https://clinicaltrials.gov/ct2/show/NCT02880280.展开更多
目的探讨血β-hCG在胎盘部位滋养细胞肿瘤(placental site trophoblastic tumors,PSTT)中的特点及其在诊断,疗效评价,病情监测中的价值。方法对1999年6月至2011年1月北京协和医院收治的40例PSTT患者的血β-hCG和临床资料进行回顾性分析...目的探讨血β-hCG在胎盘部位滋养细胞肿瘤(placental site trophoblastic tumors,PSTT)中的特点及其在诊断,疗效评价,病情监测中的价值。方法对1999年6月至2011年1月北京协和医院收治的40例PSTT患者的血β-hCG和临床资料进行回顾性分析。结果病程中最高血β-hCG0.5～8194mIU/ml,平均(1593.2±2330.7)mIU/ml;发病时血β-hCG≤1000mIU/ml28例(28/34,82.35%),病程中最高血β-hCG≤1000mIU/ml23例(23/34,67.65%);14例(14/22,63.64%)在术前化疗2个疗程后血β-hCG未下降50%;29例获得完全缓解者术前血β-hCG0.5～332.6mIU/ml,平均(75.4±97.2)mIU/ml,术后0～82.9mIU/ml,平均(6.3±15.5)mIU/ml,术后<10mIU/ml者共25例,占86.21%;7例结局不良者术前血β-hCG495～4785mIU/ml,平均1620.7mIU/ml,术后35.95～584.6mIU/ml,平均233.8mIU/ml。结论 PSTT病变的严重程度与血β-hCG的水平不成正比,血β-hCG可作为PSTT诊断的线索,疗效评价、病情监测的指标,手术前后血β-hCG变化可以一定程度预测PSTT预后。展开更多
基金supported by a grant from Jin Lei Pediatric Endocrinology Growth Research Fund for Young Physicians(PEGRF)(No.PEGRF201809006).
文摘Background:Compared to adult studies,studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism(CHH)are limited and no universal treatment regimen is available.The aim of this study was to evaluate the feasibility of human chorionic gonadotropin(hCG)/human menopausal gonadotropin(hMG)therapy for treating male adolescents with CHH.Methods:Male adolescent CHH patients were treated with hCG/hMG(n=20)or a gonadotropin-releasing hormone(GnRH)pump(n=21).The treatment was divided into a study phase(0-3 months)and a follow-up phase(3-12 months).The testicular volume(TV),penile length(PL),penis diameter(PD),and sex hormone levels were compared between the two groups.The TV and other indicators between the groups were analyzed using a t-test(equal variance)or a rank sum test(unequal variance).Results:Before treatment,there was no statistical difference between the two groups in terms of the biochemistry,hormones,and other demographic indicators.After 3 months of treatment,the TV of the hCG/hMG and GnRH groups increased to 5.1±2.3 mL and 4.1±1.8 mL,respectively;however,the difference was not statistically significant(P>0.05,t=1.394).The PL reached 6.9±1.8 cm and 5.1±1.6 cm(P<0.05,t=3.083),the PD reached 2.4±0.5 cm and 2.0±0.6 cm(P<0.05,t=2.224),respectively,in the two groups.At the end of 6 months of treatment,biomarkers were in normal range in the two groups.Compared with the GnRH group,the testosterone(T)level and growth of PL and PD were significantly greater in the hCG/hMG group(all P<0.05).While the TV of both groups increased,the difference was not statistically significant(P>0.05,t=0.314).After 9 to 12 months of treatment,the T level was higher in the hCG/hMG group.Other parameters did not exhibit a statistical difference.Conclusions:The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH.The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy.Furthermore,results from the extended time-period showed positive outcomes at the 1-year mark;however,the long-term effectiveness,strengths,and weaknesses of the hCG/hMG regimen require further research.Trial Registration:ClinicalTrials.gov,NCT02880280;https://clinicaltrials.gov/ct2/show/NCT02880280.
文摘目的探讨血β-hCG在胎盘部位滋养细胞肿瘤(placental site trophoblastic tumors,PSTT)中的特点及其在诊断,疗效评价,病情监测中的价值。方法对1999年6月至2011年1月北京协和医院收治的40例PSTT患者的血β-hCG和临床资料进行回顾性分析。结果病程中最高血β-hCG0.5～8194mIU/ml,平均(1593.2±2330.7)mIU/ml;发病时血β-hCG≤1000mIU/ml28例(28/34,82.35%),病程中最高血β-hCG≤1000mIU/ml23例(23/34,67.65%);14例(14/22,63.64%)在术前化疗2个疗程后血β-hCG未下降50%;29例获得完全缓解者术前血β-hCG0.5～332.6mIU/ml,平均(75.4±97.2)mIU/ml,术后0～82.9mIU/ml,平均(6.3±15.5)mIU/ml,术后<10mIU/ml者共25例,占86.21%;7例结局不良者术前血β-hCG495～4785mIU/ml,平均1620.7mIU/ml,术后35.95～584.6mIU/ml,平均233.8mIU/ml。结论 PSTT病变的严重程度与血β-hCG的水平不成正比,血β-hCG可作为PSTT诊断的线索,疗效评价、病情监测的指标,手术前后血β-hCG变化可以一定程度预测PSTT预后。
