Sampaolo P, Calcaterra V, Klersy C, Alfei A, De Leonardis C, Maino M, Larizza D
Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Ultrasound Obstet Gynecol. 2003 Aug;22(2):172-7. doi: 10.1002/uog.144.
Treatment with growth hormone (GH), alone or in combination with oxandrolone, is used in patients affected by Turner syndrome to improve growth velocity and adult height. Since GH interacts with gonadotropins in the stimulation of the human ovary, the aim of our study was to evaluate the possible effects of GH administration on uterine and ovarian characteristics.
We performed pelvic ultrasound assessment in 29 patients with Turner syndrome aged 7.5-16.6 years (19 with 45,X karyotype; 10 with variant karyotypes) before and during treatment with GH alone. Uterine volume and ovarian size and morphology were compared to those of 23 age-matched girls with Turner syndrome not treated with GH. Both patients and controls were divided into prepubertal and pubertal groups. Cross-sectional and longitudinal studies (before and every 6 months during GH treatment for 2 years) were performed.
We observed a significantly higher uterine anteroposterior diameter and volume in younger (< or = 11 years) GH-treated Turner syndrome girls than in those who were untreated. Also visualization and heterogeneous echopattern of the ovaries were significantly more frequent in treated than in untreated Turner syndrome patients, particularly before the age of 11 years. The longitudinal study showed a significant increase in uterine volume, more related to treatment than to age. Spontaneous breast development and menarche were found more frequently in GH-treated Turner syndrome girls.
Growth hormone therapy can have a co-gonadotropin role in patients with Turner syndrome.
生长激素（GH）单独或与氧雄龙联合使用，用于治疗特纳综合征患者，以提高生长速度和成人身高。由于GH在刺激人类卵巢时与促性腺激素相互作用，我们研究的目的是评估GH给药对子宫和卵巢特征的可能影响。
我们对29例年龄在7.5 - 16.6岁的特纳综合征患者（19例核型为45,X；10例核型为变异型）在单独使用GH治疗前和治疗期间进行了盆腔超声评估。将子宫体积、卵巢大小和形态与23例年龄匹配的未接受GH治疗的特纳综合征女孩进行比较。患者和对照组均分为青春期前和青春期组。进行了横断面研究和纵向研究（在GH治疗前以及治疗2年期间每6个月进行一次）。
我们观察到，年龄较小（≤11岁）接受GH治疗的特纳综合征女孩的子宫前后径和体积显著高于未治疗的女孩。此外，接受治疗的特纳综合征患者中卵巢的可视化和不均匀回声模式明显比未治疗的患者更常见，尤其是在11岁之前。纵向研究表明子宫体积显著增加，更多与治疗有关而非年龄。接受GH治疗的特纳综合征女孩中自发乳房发育和初潮更为常见。
生长激素治疗在特纳综合征患者中可能具有协同促性腺激素的作用。
