Leis D, Zach H, Kohler P
Arch Gynecol. 1978 Dec 29;226(4):333-9. doi: 10.1007/BF02119224.
30 hysterectomized and ovarectomized women were treated with three different estrogens: EE2 orally, E3 orally, and E3-suc intramuscularly. Each patient received one substance over 5 days doubling the dose every consecutive day, and switching to another estrogen after a treatment free interval of 2 days, rising the dosage of the second preparation twofold every consecutive day over another 5 days. Thus, each patient served as her own control with respect to 2 of the 3 tested estrogens. Six groups were required to test all sequences possible. The patients were allocated by random. GOT, GPT, LAP, AP and bilirubin were estimated daily over 2 weeks. The starting dose of EE2 was 0.25 mg, of E3 2 mg, and of E3-suc 2.5 mg.
There were marked elevations of all serum enzymes during the week of EE2 treatment. If EE2 was given in the first week, and either E3 or E3-suc in the second one there was a prompt fall of all enzyme levels in spite of the approximately tenfold higher dose of the latter two estrogens. There were only minor elevations of the enzymes after oral E3 and parenteral E3-suc in some subjects and no differences of response between these two estrogens. Bilirubin reacted with an overall rise in the majority of patients irrespective of the type of estrogen.
30名接受子宫切除和卵巢切除的女性接受了三种不同雌激素的治疗：口服炔雌醇（EE2）、口服雌三醇（E3）和肌肉注射雌三醇琥珀酸酯（E3-suc）。每位患者在5天内接受一种药物治疗，剂量每隔一天加倍，在2天的无治疗间隔后换用另一种雌激素，在接下来的5天里将第二种制剂的剂量每隔一天加倍。因此，每位患者就三种测试雌激素中的两种而言，都作为自身对照。需要六组来测试所有可能的序列。患者通过随机分配。在2周内每天测定谷草转氨酶（GOT）、谷丙转氨酶（GPT）、亮氨酸氨基肽酶（LAP）、碱性磷酸酶（AP）和胆红素。EE2的起始剂量为0.25毫克，E3为2毫克，E3-suc为2.5毫克。
在EE2治疗的一周内，所有血清酶均显著升高。如果在第一周给予EE2，在第二周给予E3或E3-suc，尽管后两种雌激素的剂量大约高十倍，但所有酶水平都会迅速下降。在一些受试者中，口服E3和注射E3-suc后，酶仅有轻微升高，且这两种雌激素之间的反应没有差异。无论雌激素类型如何，大多数患者的胆红素总体上都会升高。
