SHORT-TERM TREATMENT OF IDIOPATHIC PRECOCIOUS PUBERTY WITH A LONG-ACTING ANALOG OF LUTEINIZING-HORMONE-RELEASING HORMONE - A PRELIMINARY-REPORT
SHORT-TERM TREATMENT OF IDIOPATHIC PRECOCIOUS PUBERTY WITH A LONG-ACTING ANALOG OF LUTEINIZING-HORMONE-RELEASING HORMONE - A PRELIMINARY-REPORT
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DOI：
10.1056/nejm198112243052602
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发表时间：
1981-01-01
影响因子：
158.5
通讯作者：
CROWLEY, WF
中科院分区：
文献类型：
--
作者：
COMITE, F;CUTLER, GB;CROWLEY, WF
成人服用LHRH类似物D-Trp6-Pro9-Net-LHRH(LHRHa)时，垂体刺激和反应的解偶联，提示该药物可能用于治疗性早熟。5名特发性性早熟女孩(年龄2-8岁)接受每日皮下注射治疗8wk。注射LHRHa。这些患者有青春期发育的Tanner II-IV，骨龄较高，阴道涂片有雌激素效应，夜间分泌有脉冲的基础促性腺激素水平，以及青春期促性腺激素对LHRH的反应。阴道不规则出血3例。LHRHa显著降低基础(P<；0.025)和LHRH刺激(P<；0.01)促性腺激素水平和血清雌二醇(P<；0.05)。反映雌激素效应的阴道成熟指数得分下降了25%。停止治疗8周后，所有激素值和阴道成熟指数均恢复到治疗前水平。在充分评估LHRHa慢性治疗的益处和风险之前，这些有利的短期结果还需要进一步研究。
The uncoupling of pituitary stimulation and response observed in adults during administration of the LHRH analog, D-Trp6-Pro9-NEt-LHRH (LHRHa) suggested that this drug might be useful in treating precocious puberty. Five girls with idiopathic precocious puberty (ages 2-8 yr) were treated for 8 wk with daily s.c. injections of LHRHa. The patients had Tanner II-IV pubertal development, advanced bone age, an estrogen effect on vaginal smear, measurable basal gonadotropin levels with pulsed nocturnal secretion and a pubertal gonadotropin response to LHRH. Irregular vaginal bleeding was present in 3 patients. LHRHa significantly decreased basal (P < 0.025) and LHRH-stimulated (P < 0.01) gonadotropin levels and serum estradiol (P < 0.05). The vaginal maturation-index score, which reflects the estrogen effect, fell by 25%. Eight weeks after stopping treatment, all hormonal values and the vaginal maturation index had returned to pretreatment levels. These favorable short-term results will need further study before the benefits and risks of chronic treatment with LHRHa can be adequately assessed.