Elsedfy Heba H, Hamza Rasha Tarif, Farghaly Mohamed H, Ghazy Mohamed S
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Pediatr Endocrinol Metab. 2012;25(5-6):441-5. doi: 10.1515/jpem-2012-0040.
Our study aimed to assess uterine development in Turner syndrome patients and its relation to dose and type of estrogen therapy; and karyotype. Pelvic ultrasound was used to assess uterine size and shape, and ovarian volume in 40 Turner syndrome patients. Information on hormone replacement therapy was collected from patients' notes. Among the 40 patients studied, 57.5% started estrogen therapy and 30% were taking progestins. Sixty-five per cent had immature uterus, 17.5% had fully mature uterus and 17.5% had transitional uterus. Uterine volume was associated with age (p < 0.001), height (p = 0.002), weight (p = 0.001), years of estrogen use (p < 0.001), estrogen dose (p = 0.016), current estrogen use ( p =0.001) and Tanner breast stage ( p <0.001). Uterine volume was not affected by the type of estrogen used ( p =0.40) and karyotype ( p =0.40). Patients with Turner syndrome treated with estrogen (of adequate dose and duration) may attain a normal, mature uterine size and configuration, even at a late start of hormone replacement therapy and regardless of karyotype.
我们的研究旨在评估特纳综合征患者的子宫发育情况及其与雌激素治疗的剂量和类型以及核型的关系。采用盆腔超声检查了40例特纳综合征患者的子宫大小和形态以及卵巢体积。从患者病历中收集了激素替代治疗的相关信息。在40例研究对象中,57.5%开始了雌激素治疗,30%正在服用孕激素。65%的患者子宫未成熟,17.5%的患者子宫完全成熟,17.5%的患者子宫处于过渡状态。子宫体积与年龄(p<0.001)、身高(p=0.002)、体重(p=0.001)、使用雌激素的年限(p<0.001)、雌激素剂量(p=0.016)、当前是否使用雌激素(p=0.001)以及坦纳乳房分期(p<0.001)相关。子宫体积不受所用雌激素类型(p=0.40)和核型(p=0.40)的影响。接受(剂量和疗程合适的)雌激素治疗的特纳综合征患者,即使激素替代治疗开始较晚且不考虑核型,也可能获得正常、成熟的子宫大小和形态。