Treatment of tall girls with estrogen.
Treatment of tall girls with estrogen.
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用雌激素治疗高个子女孩。
作者：
John D. Crawford
给那些注定要长高的正常女孩服用雌激素的做法可以追溯到20世纪40年代。导致第一次审判的思路包括两个基本观察。首先，注意到持续性早熟综合征的儿童在生命早期发展成为矮小的成年人，并有过早的骨骺闭合。第二，相反，在缺乏性腺类固醇的情况下，骨骺无限期地保持开放，并且生长继续超过通常的停止年龄。虽然这些病例中的大多数都因垂体疾病的存在而变得复杂，而且由于缺乏生长激素，患者身材矮小，但早期的临床医生对后宫太监所获得的巨大体型的钦佩增强了他们对匡威的信心。
这些观察得出了两个结论。首先，性腺类固醇不仅负责关闭骨骺，而且还负责“关闭”生长激素的分泌。因此，在20世纪30年代初，人们认为，虽然儿童的天赋很好，但成年人肯定缺乏任何循环垂体生长激素，除了罕见的肢端肥大症。这些概念导致了首先用性腺提取物治疗这种疾病，然后，当纯类固醇可用时，用雄激素和雌激素治疗。睾酮的效果令人失望;然而，雌激素的有益影响是如此令人印象深刻，以至于被认为是早期得出的结论的证据，即性腺类固醇通常在青春期关闭生长激素分泌。
The practice of giving estrogen to normal girls destined to become taller than they wish goes back to the 1940s. The train of thought leading up to the first trials includes two basic observations. First, it was noted that children in whom persistent precocity syndromes develop early in life become short adults and have premature epiphyseal closure. Second, and conversely, in the absence of the gonadal steroids, the epiphyses remain open indefinitely and growth continues beyond the usual age of cessation. While the majority of these cases are complicated by the presence of pituitary disease and the fact that because of their lack of growth hormone the patients are small, the early clinicians bolstered their faith in the converse by their admiration of the enormous size reputed to be attained by the harem eunuchs.
These observations prompted two conclusions. First, gonadal steroids were not only responsible for closing the epiphyses but also for "turning off" secretion of growth hormone. Thus, in the early 1930s, it was reasoned that while children would be well endowed, adults must lack any circulating pituitary growth hormone, save in the rare instance of acromegaly. These were the concepts that led to the treatment of that disorder first with gonadal extracts,1,2 then, when pure steroids became available, with androgens and estrogens.3 The effect of testosterone was disappointing; the beneficial influence of estrogen, however, was so impressive as to be taken as proof of the earlier drawn conclusion that it is the gonadal steroids that normally turn off growth hormone secretion at adolescence.