Glucocorticoid treatment of girls with congenital adrenal hyperplasia: effects on height, sexual maturation, and fertility.
Glucocorticoid treatment of girls with congenital adrenal hyperplasia: effects on height, sexual maturation, and fertility.
复制标题
先天性肾上腺增生女孩的糖皮质激素治疗：对身高、性成熟和生育能力的影响。
DOI：
10.1016/s0022-3476(77)80581-7
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发表时间：
1977
期刊：
影响因子：
--
通讯作者：
R. M. Blizzard
中科院分区：
文献类型：
--
作者：
G. Klingensmith;Silvia Cristina Garcia;H. W. Jones;C. Migeon;R. M. Blizzard
Ninety-eight females with congenital adrenal hyperplasia due to a defect in either the 21-hydroxylase or the 11β-hydroxylase enzyme were evaluated to determine the effects of glucocorticoid treatment on growth, pubertal development, and fertility. When treatment was begun prior to one year of age, mean final height was 157.4±7.3 cm, well within the normal adult female range, and significantly (p<0.001) greater than the mean final height of 150.9±4.3 cm found in untreated patients. The mean age of menarche in patients treated prior to the age of six years was 13.8±3.7 years which is significantly (p<0.01) delayed compared to that in the normal population of the United States. However, 92% of patients with menstrual delay had inadequate suppression of adrenal androgens and urinary excretion of 17 ketosteroids>7.0 mg/24 hours. The increased production of adrenal androgens was the result of poor compliance or an insufficient prescribed dose of glucocorticoids. The fertility rate in patients first treated between six and 20 years of age was 64%. The excretion of urinary 17 KS at the time of pregnancy was 2.5 to 5.3 mg/24 hours. All of the patients who delivered term infants required delivery by cesarean section because of cephalopelvic disproportion. The major problems encountered in the management of adolescent patients were patient noncompliance and physician failure to increase the glucocorticoid dose as the patient's body size increased.
