Illig R, DeCampo C, Lang-Muritano M R, Prader A, Torresani T, Werder E A, Willi U, Schenkel L
Department of Paediatrics, Kinderspital, Zurich, Switzerland.
Eur J Pediatr. 1990 Dec;150(2):86-91. doi: 10.1007/BF02072044.
Transdermal 17 beta-oestradiol administration (17 beta-E2), used mainly in menopausal women, allows a continuous 17 beta-E2 delivery through the skin into the systemic circulation, avoiding intestinal and hepatic passage. In order to explore whether transdermal 17 beta-E2 could be used for the induction of puberty, 17 beta-E2 patches with low dose delivery were administered in nine prepubertal girls with Turner syndrome (bone age greater than 10.5 years) for a mean period of 2.2 years. Treatment schedule: 5 micrograms/day for 6-9 months, 10 micrograms/day for 6-9 months, 25 micrograms/day for long-term substitution; addition of cyclic gestagen p.o. after 18-24 months. Breast development started within 3 months of therapy and menstruation occurred after 2 years. Growth rate increased from 3.2 to 5.0 cm/year during the 1st year of therapy, height prediction did not change. Serum oestradiol (E2) and urinary E2 conjugates increased proportionally with 17 beta-E2 doses, serum oestrone (E1) rose much less. The possibility to imitate time course, clinical events and hormonal changes of normal puberty, the absence of adverse drug reactions and the excellent acceptance and easy mode of application suggest that transdermal 17 beta-E2 is optimally suited for hormonal substitution in girls with hypogonadism.
经皮给予 17β-雌二醇（17β-E2）主要用于绝经后女性，可使 17β-E2 通过皮肤持续释放进入体循环，避免经过肠道和肝脏。为探究经皮给予 17β-E2 是否可用于诱导青春期，对 9 名患有特纳综合征（骨龄大于 10.5 岁）的青春期前女孩给予低剂量释放的 17β-E2 贴片，平均给药时间为 2.2 年。治疗方案：每天 5 微克，持续 6 - 9 个月；每天 10 微克，持续 6 - 9 个月；每天 25 微克用于长期替代；18 - 24 个月后口服添加周期性孕激素。治疗 3 个月内开始乳房发育，2 年后出现月经。治疗第 1 年生长速率从 3.2 厘米/年增加至 5.0 厘米/年，身高预测无变化。血清雌二醇（E2）和尿 E2 结合物与 17β-E2 剂量成比例增加，血清雌酮（E1）升高幅度小得多。能够模拟正常青春期的时间进程、临床事件和激素变化，无药物不良反应，且接受度高、应用方式简便，表明经皮给予 17β-E2 非常适合性腺功能减退女孩的激素替代治疗。
