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[特纳综合征:医疗护理方面有哪些新进展?]

[Turner Syndrome: what's new in medical care?].

作者信息

Zenaty D, Laurent M, Carel J C, Léger J

机构信息

Inserm UMR, service endocrinologie-diabétologie pédiatrique, centre référence maladies endocriniennes rares de la croissance, université Paris-Diderot, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, France.

出版信息

Arch Pediatr. 2011 Dec;18(12):1343-7. doi: 10.1016/j.arcped.2011.09.002. Epub 2011 Oct 29.

Abstract

Turner syndrome is a rare genetic disorder, affecting approximately one in 2500 live-born female, due to total or partial absence of the X chromosome. Typical clinical features are short stature and premature ovarian failure and less constantly phenotypic particularities such as congenital malformations, acquired cardiovascular, otological (hearing impairment), autoimmune and metabolic pathologies. The phenotype is highly variable with slight or even normal phenotype. Several studies have shown that growth hormone treatment improves adult height. The possibility of pregnancies after oocyte donation highlights the high risk of these pregnancies requiring a careful follow-up, especially in terms of cardiovascular issues. Although the quality of life seems similar to the normal population, the presence of cardiovascular and otological diseases, and delayed feminisation are associated with an impaired quality of life. Early diagnosis and regular screening for potentials associated complications are essential in the medical follow-up of these patients. The recent publication of recommendations should lead to an optimization and harmonisation of the medical practices and follow-up from paediatric age to adulthood, a lowering morbidity and self-esteem improvement. The interest of ovarian cryopreservation at an early age in these patients is under investigation.

摘要

特纳综合征是一种罕见的遗传性疾病,由于X染色体完全或部分缺失,每2500名活产女性中约有1人受其影响。典型的临床特征是身材矮小和卵巢早衰,不太常见的表型特征如先天性畸形、后天性心血管疾病、耳科疾病(听力障碍)、自身免疫性疾病和代谢性疾病。其表型差异很大,可能有轻微甚至正常的表型。多项研究表明,生长激素治疗可提高成年身高。卵母细胞捐赠后怀孕的可能性凸显了这些怀孕的高风险,需要仔细随访,尤其是在心血管问题方面。尽管生活质量似乎与正常人群相似,但心血管和耳科疾病的存在以及女性化延迟与生活质量受损有关。在这些患者的医学随访中,早期诊断和定期筛查潜在的相关并发症至关重要。最近发布的建议应能优化和统一从儿童期到成年期的医疗实践和随访,降低发病率并提高自尊。这些患者在幼年时进行卵巢冷冻保存的意义正在研究中。

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