摘要
目的:评估抗雌激素药它莫西芬和雷洛昔芬在治疗青春期持续性男性乳房发育的效果。研究设计:回顾性研究38例在一个儿童内分泌科就诊的青春期持续性男性乳房发育的患儿。患儿仅得到保证或3-9个月疗程的雌激素受体抑制剂(它莫西芬和雷洛昔芬)的治疗。结果:患儿平均年龄为14.6岁(s=1.5岁),患男性乳房发育的平均持续时间为28.3月(s=16.4月)。在使用它莫西芬和雷洛西芬后,胸部结节直径平均减少分别为2.1cm(95%CI 1.7-2.7,P【0.0001)和2.5 cm(95% CI 1.7-3.3,P【0.0001)。在使用它莫西芬和雷洛昔芬后,分别可看到86%和91%的患儿得到改善,但是,
Objectives To assess the efficacy of the anti-estrogens ta-moxifen and raloxifen in the medical management of persistent pubertal gynecomastia. Study design Retrospective chart review of 38 consecutive patients with persistent pubertal gynecomastia who presented to a pediatric endocrinology clinic. Patients received reassurance alone or a 3 - to 9 -month course of an estrogen receptor modifier (tamoxifen or raloxifene) . Results Mean (SD) age of treated subjects was 14. 6 (1. 5) years with gynecomastia duration of 28. 3 (16. 4) months. Mean reduction in breast nodule diameter was 2. 1 cm (95% CI 1. 7, 2. 7, P < . 0001) after treatment with tamoxifen and 2. 5 cm (95% CI 1. 7, 3.3, P < . 0001) with raloxifene. Some improvement was seen in 86% of patients receiving tamoxifen and in 91% receiving raloxifene, but a greater proportion had a significant decrease (> 50% ) with raloxifene (86% ) than tamoxifen (41% ) . No side ef-fectswere seen in any patients. Conclusion Inhibition of e-strogen receptor action in the breast appears to be safe and effective in reducing persistent pubertal gynecomastia, with a better response to raloxifene than to tamoxifen. Further study is required to determine that this is truly a treatment effect.
