摘要
为探索雄激素拮抗剂氟他胺在先天性肾上腺皮质增生症(CAH)治疗中应用价值 ,对5例经传统糖皮质激素治疗后临床控制不良的CAH患儿 ,在原糖皮质激素治疗剂量不变或减少情况下 ,加用氟他胺7.5～10mg/(kg·d)治疗6个月左右 ,以观察该新方案治疗前后临床指标及内分泌激素变化。结果显示 :氟他胺联合治疗后 ,生长速率由(10.6±2.3)cm/y减至(5.9±1.3)cm/y(P<0.05) ;血睾酮水平明显下降 ,由5.5 ,39.2(M ,Q)nmol/L降至0.2 ,9.7nmol/L(P<0.05) ;血17 -羟孕酮、脱氢表雄酮、雄稀二酮及尿17 -酮类固醇水平也均有不同程度下降。研究表明氟他胺联合较低剂量糖皮质激素治疗 ,可使CAH患儿生长速率正常化 ,改善高雄激素血症。
To evaluate the effect of antiandrogen(flutamide)on the treatment of congenital adrenal hyperplasia(CAH),five patients(4 males and 1 female) aged at 5.8±1.8 years old with 21_hydroxylase deficient CAH poorly controlled with glucocorticoid treatment were enrolled into this study.These patients were treated for six months with combination of flutamide(7.5～10 mg/kg·d) and glucocorticoid at the same or an one third reduced dosage.The results showed that the growth velocity of these patients was remarkably decelerated from 10.6±2.3 cm/y to 5.9±1.3 cm/y(P<0.05);serum testosterone levels decreased from 5.5,39.2(M,Q)nmol/L to 0.2,9.7 nmol/L(P<0.05);other androgen or its metabolites such as blood 17_hydroxyprogesterone(17_OHP),dehydroepiandrosterone(DHEA),androstenedione(A)and 24h urine 17_ketosteroid(17_KS) were also reduced in different degree after new protocol therapy,Suggesting that the normalization of growth velocity and improvement of hyperandrogenism in CAH patients could be achieved with flutamide and lower dosage of glucocorticoid combination treatment.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2003年第7期390-393,共4页
Journal of Clinical Pediatrics
关键词
雄激素拮抗剂
氟他胺
先天性肾上腺皮质增生症
治疗
应用
congenital adrenal hyperplasia 21_hydroxylase deficiency flutamide glucocorticoid androgen
