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对过高女孩的雌激素治疗。

Estrogen treatment of excessively tall girls.

作者信息

Zachmann M, Ferrandez A, Můrset G, Prader A

出版信息

Helv Paediatr Acta. 1975 May;30(1):11-30.

PMID:169220
Abstract

40 excessively tall girls with a mean height prediction of 182 cm were treated for serious psychosocial reasons continuously with ethinylestradiol 0.3 mg daily and with norethisterone 10 mg daily for 5-7 days every 4th week. Their age at the start of treatment ranged from 9.4 to 13.8 years, and the mean duration of treatment was 1.7 years. Bone age was assessed according to the TANNER-WHITEHOUSE-II (RUS) method, and height predictions were calculated using the age-specific regression equations of TANNER et al. Results were compared with those in 9 untreated control cases. Mean reduction of predicted height in all patients was 4.6 +/- 2.4 cm, and the most marked reduction was found in the youngest group of patients. However, even in patients after menarche and with a bone age above 14 years at start of treatment, there was still a considerable reduction of adult height. Bone maturation was accelerated by treatment (1.4 years per year), and the most marked acceleration was observed during the first 6 months (1.7 years per year). Growth velocity was normal or slightly subnormal during the first 6 months and very low thereafter. During treatment, there was a considerable weight gain which was, in part, lost again when treatment was discontinued. Posttherapeutic amenorrhea was infrequent, and normal and regular menstruations reappeared in the majority of the patients about 1 month after discontinuation. It is concluded that estrogen treatment in high doses is effective in reducing adult stature in girls and that somatic and psychological side effects are minimal when treatment is started after onset of spontaneous puberty. Although early treatment tends to give better results, beneficial results may still be obtained in older patients.

摘要

40名平均身高预测为182厘米的过高女孩,因严重的心理社会原因,连续接受治疗,每天服用0.3毫克炔雌醇,每4周服用5 - 7天,每天服用10毫克炔诺酮。她们开始治疗时的年龄在9.4岁至13.8岁之间,平均治疗持续时间为1.7年。根据TANNER - WHITEHOUSE - II(RUS)方法评估骨龄,并使用TANNER等人的年龄特异性回归方程计算身高预测值。将结果与9例未治疗的对照病例进行比较。所有患者预测身高的平均降低值为4.6 +/- 2.4厘米,最显著的降低出现在最年轻的患者组中。然而,即使是初潮后且开始治疗时骨龄超过14岁的患者,成年身高仍有相当程度的降低。治疗使骨成熟加速(每年1.4岁),最显著的加速在最初6个月观察到(每年1.7岁)。最初6个月生长速度正常或略低于正常,此后非常低。治疗期间体重有相当程度的增加,部分在停药后又减轻。治疗后闭经不常见,大多数患者在停药后约1个月恢复正常且规律的月经。结论是高剂量雌激素治疗对降低女孩成年身高有效,且在自发青春期开始后开始治疗时,躯体和心理副作用最小。虽然早期治疗往往效果更好,但老年患者仍可能获得有益结果。

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