Abstract：
OBJECTIVE: We aimed to identify critical factors for uterine development by comparing uterine volume (UV) among patients with Turner syndrome (TS) who underwent pubertal induction (PI), patients with TS who had natural menarche (NM), and patients in a non-TS control group.
METHODS: This retrospective case-control study included patients with TS who had undergone PI with oral estrogen in a PI group(n=31) and a NM group(n=7). The control group included patients without TS with spontaneous puberty who underwent pelvic ultrasound at 16 years of age. For TS patients, both the UV from the first ultrasound performed at age 16 or older (1st-UV) and the UV from the most recent final ultrasound (final-UV) were obtained.
RESULTS: The 1st-UV was larger for patients in the NM group than those in the PI group (p<0.001), but did not differ significantly between the NM and control groups (p=0.375). The final-UV of the PI group was larger than their 1st-UV (p<0.001), but still smaller than the NM group (p=0.021). HRT duration and 1st-UV of PI group were positively correlated (p=0.048). There were no variables that were significantly correlated with final-UV of PI group.
CONCLUSIONS: Patients with TS who experienced NM showed normal uterine development, but TS patients who underwent PI showed significantly smaller, undeveloped UV. While HRT duration and UV are positively correlated at the beginning of HRT, it is unclear what determines the final UV; however, late PI initiation and use of oral estrogen probably contributed to the lack of UV development.
METHODS: This retrospective case-control study included patients with TS who had undergone PI with oral estrogen in a PI group(n=31) and a NM group(n=7). The control group included patients without TS with spontaneous puberty who underwent pelvic ultrasound at 16 years of age. For TS patients, both the UV from the first ultrasound performed at age 16 or older (1st-UV) and the UV from the most recent final ultrasound (final-UV) were obtained.
RESULTS: The 1st-UV was larger for patients in the NM group than those in the PI group (p<0.001), but did not differ significantly between the NM and control groups (p=0.375). The final-UV of the PI group was larger than their 1st-UV (p<0.001), but still smaller than the NM group (p=0.021). HRT duration and 1st-UV of PI group were positively correlated (p=0.048). There were no variables that were significantly correlated with final-UV of PI group.
CONCLUSIONS: Patients with TS who experienced NM showed normal uterine development, but TS patients who underwent PI showed significantly smaller, undeveloped UV. While HRT duration and UV are positively correlated at the beginning of HRT, it is unclear what determines the final UV; however, late PI initiation and use of oral estrogen probably contributed to the lack of UV development.
摘要：
目的：我们旨在通过比较接受青春期诱导（PI）的特纳综合征（TS）患者的子宫体积（UV）来确定子宫发育的关键因素。患有自然初潮（NM）的TS患者，和非TS对照组的患者。
方法：这项回顾性病例对照研究包括接受PI和NM组（n=7）口服雌激素的TS患者。对照组包括没有TS的自发性青春期患者，他们在16岁时接受了盆腔超声检查。对于TS患者，获得了来自16岁或以上进行的第一次超声的UV(第一次UV)和来自最近一次最终超声的UV(最终UV)。
结果：NM组患者的1st-UV大于PI组患者（p<0.001），但NM组和对照组之间没有显着差异（p=0.375）。PI组的最终UV大于其第一UV（p<0.001），但仍小于NM组(p=0.021)。PI组的HRT持续时间与第1-UV呈正相关(p=0.048)。没有变量与PI组的最终UV显着相关。
结论：经历NM的TS患者表现出正常的子宫发育，但是接受PI的TS患者表现出明显较小，未开发的紫外线。虽然HRT持续时间和紫外线在HRT开始时呈正相关，目前还不清楚是什么决定了最终的紫外线；然而，晚期PI启动和口服雌激素的使用可能是导致紫外线缺乏的原因。
方法：这项回顾性病例对照研究包括接受PI和NM组（n=7）口服雌激素的TS患者。对照组包括没有TS的自发性青春期患者，他们在16岁时接受了盆腔超声检查。对于TS患者，获得了来自16岁或以上进行的第一次超声的UV(第一次UV)和来自最近一次最终超声的UV(最终UV)。
结果：NM组患者的1st-UV大于PI组患者（p<0.001），但NM组和对照组之间没有显着差异（p=0.375）。PI组的最终UV大于其第一UV（p<0.001），但仍小于NM组(p=0.021)。PI组的HRT持续时间与第1-UV呈正相关(p=0.048)。没有变量与PI组的最终UV显着相关。
结论：经历NM的TS患者表现出正常的子宫发育，但是接受PI的TS患者表现出明显较小，未开发的紫外线。虽然HRT持续时间和紫外线在HRT开始时呈正相关，目前还不清楚是什么决定了最终的紫外线；然而，晚期PI启动和口服雌激素的使用可能是导致紫外线缺乏的原因。
