Dewhurst C J, de Koos E B, Haines R M
Br J Obstet Gynaecol. 1975 May;82(5):412-6. doi: 10.1111/j.1471-0528.1975.tb00657.x.
Curettage carried out during the third week of treatment of ethinyl oestradiol in 14 patients with gonadal dysgenesis showed cystic glandular hyperplasia in seven patients developed a large endometrial polyp and in one atypical changes were found in the hyperplastic endometrium. In seven patients treated by an oestrogen-progestogen combination normal secretory endometrium was seen in five, proliferative change only in one (thought to be due to incorrect timing of the curettage) and a small proliferative polyp in association with secretory endometrium elsewhere in the uterus in the seventh. In view of these changes and report of adenocarcinoma of the endometrium in patients with gonadal dysgenesis treated with oestrogens alone it is suggested that a regime of low dose oestrogen therapy for 21 days accompanied by a progestogen on days 15 to 21 is preferable to oestrogens alone.
对14例性腺发育不全患者在炔雌醇治疗的第三周进行刮宫，结果显示，7例患者出现囊性腺性增生，1例出现大的子宫内膜息肉，1例增生的子宫内膜有非典型改变。在7例接受雌激素 - 孕激素联合治疗的患者中，5例可见正常分泌期子宫内膜，1例仅见增殖性改变（认为是刮宫时间不正确所致），第7例患者子宫其他部位为分泌期子宫内膜，同时伴有一个小的增殖性息肉。鉴于这些变化以及单独使用雌激素治疗的性腺发育不全患者发生子宫内膜腺癌的报道，建议采用低剂量雌激素治疗21天，并在第15至21天加用孕激素，这种方案优于单独使用雌激素。
