Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gynecol Endocrinol. 2012 Feb;28(2):130-3. doi: 10.3109/09513590.2011.588752. Epub 2011 Jul 27.
We conducted this study to find the adequate initial estrogen dose for adolescent girls with Turner Syndrome (TS). We reviewed the medical records of 19 girls with TS and premature ovarian failure (POF), aged 13 to 17 years, who were referred to our adolescent gynecology clinic for ERT. Nine patients were treated with 0.5 mg estradiol valerate (EV) and 10 patients were treated with 1 mg EV as an initial estrogen dose for 1 year. Breast development, changes in uterine size and bone mineral density were measured before and after 1 year of ERT. All patients showed breast budding after 1 year of ERT regardless of estrogen dosage. Uterine development in patients treated with 1 mg EV advanced farther in 1 year of treatment than in patients given 0.5 mg EV. In patients treated with 1 mg EV, uterine length increased by 39.8% and AP fundal diameter by 46%, increments greater than in patients receiving 0.5 mg EV. After 1 year of ERT, bone mineral densities (BMD) increased significantly in both groups, although BMD did not differ significantly between the groups. In conclusion, ERT with 1mg of EV, as a starting dose induced better uterine development than 0.5 mg in prepubertal girls with TS.
我们进行这项研究是为了找到特纳综合征（TS）青春期女孩合适的初始雌激素剂量。我们回顾了 19 名年龄在 13 至 17 岁之间、因卵巢早衰（POF）而被转诊至我们青春期妇科诊所接受雌激素替代疗法（ERT）的 TS 患者的病历。9 名患者接受 0.5 毫克戊酸雌二醇（EV）治疗，10 名患者接受 1 毫克 EV 作为初始雌激素剂量治疗 1 年。在 ERT 前和 1 年后测量乳房发育、子宫大小和骨密度的变化。所有患者在 ERT 1 年后均出现乳房发育，无论雌激素剂量如何。在接受 1 毫克 EV 治疗的患者中，子宫发育在 1 年的治疗中比接受 0.5 毫克 EV 治疗的患者进展得更远。在接受 1 毫克 EV 治疗的患者中，子宫长度增加了 39.8%，AP 宫底直径增加了 46%，增量大于接受 0.5 毫克 EV 治疗的患者。ERT 1 年后，两组的骨密度（BMD）均显著增加，尽管两组之间的 BMD 无显著差异。总之，1 毫克 EV 作为起始剂量的 ERT 可诱导 TS 青春期前女孩的子宫发育优于 0.5 毫克 EV。
