青春期后女性痤疮患者血清性激素水平的研究

目的：检测青春期后女性痤疮患者体内性激素的水平。方法：采用放射免疫法对25岁以上的34例女性痤疮患者血清睾酮（T）、雌二醇（E2）、泌尿素（PRL）、黄体生成素（LH）和卵泡刺激素（FSH）进行了测定，并以32例正常女性作为对照。结果：患者组T显著高于对照组（P＜0．001）；E2和LH显著低于对照组（P＜0．001）；PRL和FSH无明显变化（P＞0．05）。结论：性激素异常可能是女性痤疮迟发和持久不退的主要原因。     

女性寻常性痤疮患者免疫球蛋白补体及可溶性IL-2R的检测

目的：探讨女性寻常性痤疮患者细胞及体液免疫功能状况。方法：采用速率散射比浊法测定58例女性寻常性痤疮患者免疫球蛋白IgG,IgA,IgM及补体C3、C4；采用ELISA双抗体夹心法测定58例女性寻常性痤疮患者血清可溶性白细胞介不2受体(sIL-2R）水平；同时以30例正常女性作为对照。结果：患者组免疫球蛋白IgG,IgA,IgM及补体C3、C4无明显变化；但痤疮严重程度不同，IgG的变化差异有显著性（P＜0．001），其余指标差异无显著性，Ⅰ度组IgG明显低于正常对照组（P＜0．01）；Ⅱ度组与正常对照差异无显著性（P＞0．05）；Ⅲ度组较正常对照组明显升高（P＜0．001）。痤疮越严重，IgG越高，Ⅱ度组显著高于Ⅰ度组（P＜0．05），Ⅲ度组显著高于Ⅱ度组（P＜0．001），血清sIL-2R水平明显高于正常人对照（P＜0．001）。结论：免疫反应参与了痤疮的发病过程，免疫反应答涉及及到体液免疫及细胞免疫两个途径。     

寻常痤疮中医证素号陛激素的相关性研究

目的探讨寻常痤疮证素（辨证要素）规律及其内分泌机理。方法①采用流行病学方法调查青年学生840人。②选择70例痤疮患者为对象,15名健康人为对照,以证素辨证和性激素为指标。结果①痤疮患病率86．9％;病位证素属肝比例最大,肾次之;病性证素中属热者比例最大,阴虚次之（P〈0．01）。②男、女患者的睾酮（T）值均高于正常对照组（P〈0．01、P〈0．05）,雌二醇（E2）、卵泡刺激素（FSH）、黄体生成激素（LH）差异无统计学意义（P〉0．05）。③男性患者肝郁化火型的LH／FSH显著高于心火旺盛、肺经风热、肾虚火旺型（P〈0．01-P〈0．05）;湿热蕴脾型的LH／FSH显著高于心火旺盛和肺经风热型（P〈0．05）。女性患者性激素组间差异无统计学意义（P〉0．05）。结论痤疮病位以肝、肾为主。病性以热证多见,证候形成与性激素变化有关,其中T值升高可能是热证形成的物质基础。     

伴多囊卵巢综合征的痤疮性激素水平变化及相关分析

为探讨成年女性痤疮患者血清性激素水平的变化及与多囊卵巢综合征（PCOS）的相关性，对60例成年女性痤疮患者进行血清性激素水平测定和妇科B超检查，其中24例伴PCOS痤疮患者行腹腔镜下微波治疗。结果发现患者组血清睾酮（T），黄体生成素（LH）高于对照组（P＜0．05），微波术后其T，LH值明显下降（P＜0．05），该手术对痤疮治愈率和总有效率分别为58．3％和91．7％，提示成年女性痊痤疮与PCOS有相关性，高雄激素血症可能是引起女性痤疮的主要因素之一。     

女性寻常痤疮患者甲状腺激素与性激素的测定及其相互关系的研究

目的：了解女性痤疮患者甲状腺功能的状况及性激素与甲状腺激素的关系。方法：采用放射免疫分析方法，对54例女性座疮患者和30例正常对照者血清中甲状腺激素及8项性激素进行测定。结果：所有痤疮患者及正常对照者血清T3、T4、TSH水平均在所用试剂盒所列正常范围内。但通过患者组与对照组比较发现，患者组T4水平高于正常对照组，差异有高度显著性（P＜0．01），而T3及TSH无明显变化；相关分析结果表明，T4与各项性激素间均无明显相关（P＞0．05）。结论：与正常对照组相比，女性痤疮患者血清T4水平存在有整体差别；在痤疮的发病中，甲状腺激素可能是在毛囊水平发挥作用。     

女性痤疮与多囊卵巢综合征的相关性研究

目的 检测成年女性痤疮患者体内性激素水平的变化，探讨其与多囊卵巢综合征（PCOS）的相关性。方法 采用放射免疫分析法,对50例痤疮患者进行血清性激素水平测定和妇科经阴道超声检查。以30例正常成年女性为对照。结果 痤疮组睾酮、二氢睾酮、脱氢表雄酮及黄体生成素水平增高，与正常对照组比较差异有高度显著性（P＜0．001或P＜0．01）；雌二醇、卵泡刺激素、孕酮水平变化不明显（P均＞0．05）。50例中有28例患PCOS。对其中10例应用达英－35治疗，可降低血清雄激素水平。结论 高雄激素血症和PCOS与成年女性痤疮有关，且是其长期不愈的重要原因。达英－35对此类痤疮有较好疗效。     

观察不孕症患者性激素水平检测的临床价值

目的观察不孕症患者性激素水平检测的临床价值。方法随机选取2015年5月至2017年5月深圳市罗湖区妇幼保健院诊治的60例不孕症患者为研究对象,依据疾病类型将其分为原发性不孕组和继发性不孕组,每组30例患者;同时,选取来深圳市罗湖区妇幼保健院进行健康体检的30例已育女性作为正常对照组:对三组人员的血清性激素6项指标水平进行统计分析。结果原发性不孕组、继发性不孕组患者的血清促卵泡生成素(FSH)、黄体生成素(LH)、孕酮(P)、睾酮(T)和雌二醇(E2)水平均显著低于正常对照组(均P0.05),血清泌乳素(PRL)水平均高于正常对照组(P0.05);同时,原发性不孕组患者的血清PRL水平显著高于继发性不孕组(P0.05)。卵泡期,原发性不孕组、继发性不孕组患者的血清FSH、T和E2水平均显著低于正常对照组成员(均P0.05),血清PRL、P水平均显著高于正常对照组成员(均P0.05)。排卵期,原发性不孕组、继发性不孕组患者的血清LH、FSH、T、P和E2水平均显著低于正常对照组(均P0.05)。黄体期,原发性不孕组、继发性不孕组患者的血清LH、PRL水平均显著高于正常对照组患者(均P0.05),血清P水平均显著低于正常对照组患者(P0.05)。结论检测不孕症患者性激素水平具有较高的临床价值,能够为临床诊断不孕症提供依据,并有效鉴别诊断原发性不孕与继发性不孕及其所处时期。     

性激素水平与痤疮中医分型的关系研究

目的探讨性激素水平与痤疮中医分型的关系。方法采用放射免疫双抗法进行血清LH,FSH,E2,T,PRL水平的检测。结果女性肝郁气滞型痤疮患者血清性激素水平与女性湿热内蕴型痤疮患者血清性激素水平比较,LH差异无显著性(P>0.05);FSH,E2,T,PRL,LH/FSH差异均有显著性(P<0.01);男性肝郁气滞型痤疮患者血清性激素水平与男性湿热内蕴型痤疮患者血清性激素水平进行比较,血清T,PRL差异有显著性(P<0.05)。结论性激素水平与痤疮中医分型有关。PRL,LH/FSH是肝郁气滞型痤疮患者中医分型的微观物质基础,而T是湿热内蕴型痤疮患者中医分型的微观物质基础。     

颧部褐青色痣与性激素相关性的研究

目的:探讨颧部褐青色痣（NFZ）患者血清性激素水平及皮损性激素受体与NFZ发病的相关性。方法: 采用免疫组化法检测雌激素受体（ER）、孕激素受体（PR）及雄激素受体（AR）在10例NFZ及蓝痣石蜡标本上的表达，同时对30例女性NFZ患者采用放射免疫法检测血清性激素（FSH 、P、 E2 、T、LH 及PRL）的水平,并将其结果与健康女性血清性激素水平加以比较。结果:NFZ皮损真皮黑素细胞免疫组化染色有5例AR阳性，ER和PR均为阴性，NFZ患者与健康人比较,血清E2、P、T、FSH、LH、PRL差异无显著性（p>0.05）。结论:NFZ的发病与性激素E2、P、T、FSH、LH、PRL水平无关，但其黑素细胞有雄激素受体。     

女性不孕症患者血清性激素水平的变化及临床意义

目的:探讨女性不孕症患者血清性激素水平的变化及临床意义。方法:回顾性分析118例不孕症患者(月经正常组38例,月经异常组80例)与78例健康对照组个体血清性激素水平的变化,并将病因明确的月经异常不孕症患者的血清性激素水平与对照组比较。结果:月经正常不孕症患者与对照组相比,FSH、LH、PRL、T、E2和P水平均略有增高,但无统计学差异(P0.05)。月经异常不孕症患者与对照组相比,FSH、LH、PRL和P水平均明显升高(P0.05),而E2水平显著降低(P0.05)。月经异常不孕症患者与月经正常不孕症患者相比,FSH、LH、PRL和P水平均明显升高(P0.05),而E2水平显著降低(P0.05)。将病因明确的月经异常不孕症患者与对照组血清性激素比较,发现催乳素血症患者和垂体微腺瘤患者在FSH、LH、PRL和P水平明显升高(P0.05),而E2水平显著降低(P0.05);子宫卵巢功能异常患者在LH、T和P水平上均显著升高(P0.05);黄体功能异常患者在LH和P水平上均显著升高(P0.05)。结论:月经异常不孕症患者的发病因素主要与内分泌紊乱有关,而月经正常的不孕症患者不完全是内分泌紊乱引起,其他病因也可能参与其中。血清性激素水平变化可以为女性月经异常不孕症患者的诊断提供参考依据。     

女性痤疮患者卵泡期血清六项性激素水平的测定

目的探讨女性寻常痤疮患者体内性激素水平的改变。方法采用电化学发光免疫分析法对30例青春期女性痤疮患者及20例迟发性女性痤疮患者卵泡期血清六项性激素水平进行检测,并分别与相应年龄段的正常女性各15人作对照。结果女性青春期痤疮患者血清雌二醇水平明显低于同龄正常对照组(P<0.05);睾酮/雌二醇比值明显高于正常对照组(P<0.01);促卵泡素明显高于正常对照组(P<0.05);女性迟发性痤疮患者血清睾酮水平较相应年龄的正常对照组显著升高(P<0.05)。结论青春期女性痤疮发病的主要原因可能是由于雌激素分泌不足,使血清内睾酮水平相对增多所致。女性迟发性痤疮发病的主要原因则可能与雄激素分泌增多有关。     

66例痤疮患者血清睾酮及雌二醇水平研究

对６６例痤疮患者和２０名正常人的血清睾酮及雌二醇水平进行检测。结果显示：伴有多毛现象女性患者的血清睾酮水平和男性患者的雌二醇水平明显高于正常对照组（Ｐ〈０．０５），提示痤疮发生与性激素水平改变有关。     

524例青春期后女性痤疮患者的性激素和血脂分析

目的：检测青春期后女性痤疮患者血脂和性激素水平变化情况,探讨痤疮与性激素和血脂的关系。方法：收集青春期后女性寻常痤疮患者和健康对照者,检测BMI、甘油三酯、高密度脂蛋白、垂体泌乳素、促卵泡生成素、促黄体生成素、睾酮和硫酸脱氢表雄酮水平和盆腔超声。结果：共纳入524例青春期后女性痤疮患者（轻、中、重度痤疮分别为239例,207例和78例）及50名健康对照。轻、中、重度患者垂体泌乳素、雄烯二酮和硫酸脱氢表雄酮均显著高于健康对照者（P<0.05）。379例患者无多囊卵巢综合征（PCOS）,其中高雄烯二酮患者62例,雄烯二酮水平正常者317例。较雄烯二酮正常组,高雄烯二酮组垂体泌乳素、促黄体生成素、睾酮、硫酸脱氢表雄酮及高密度脂蛋白水平升高,甘油三酯水平降低（均P<0.05）。结论：青春期后女性痤疮患者易合并多种性激素异常,其中雄激素水平升高明显。     

Serum hormone levels in men with severe acne.

In order to evaluate the hormonal milieu in young men with severe acne, we measured serum estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) levels in sixteen male patients aged 20-30 years with severe acne, including twelve cases of nodular-cystic acne, and in seventeen age-matched normal controls. There were no significant differences in the serum levels of T, FT, DHT, DHEA-S, or SHBG between the patients and the controls, but serum E2 was significantly higher in the patient population. Thus, the hemodynamics of serum androgens in male patients with acne do not seem to differ significantly from that of normal controls. Elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymic hormones, as reported in the literature.     

妊娠期痤疮患者雄激素和垂体激素水平研究

目的:探讨妊娠期痤疮患者体内性激素水平的改变。方法:采用化学发光酶免疫分析法测定50例妊娠患者血清中的黄体生成素(LH)、卵泡刺激素(FSH)和睾酮(T)的水平,并以50例正常孕妇做对照。结果:患者组LH和FSH显著高于对照组(P<0.05),T略高于对照组,差异无显著性(P>0.05)。结论:在妊娠期痤疮患者中雄激素水平不是发病的决定性因素。     

Pituitary function and DHEA-S in male acne and DHEA-S, prolactin and cortisol before and after oral contraceptive treatment in female acne

Pituitary function (TRH-LHRH stimulation test) was investigated in male acne patients and serum levels of dehydroepiandrosterone sulphate (DHEA-S), sex hormone binding globulin (SHBG) and other biochemical parameters were investigated in male acne patients and in female acne patients before and after treatment with an oral contraceptive. The TRH-LHRH stimulation test was performed with 15 male patients suffering from severe cystic acne and 7 healthy volunteers. Basal and stimulated prolactin, LH and FSH levels were statistically similar in the patients and control groups. However, the stimulated LH levels of the patients were 60% higher than those in controls. SHBG levels were significantly) higher in the patient group compared to those in the control group. Thirty-three female acne patients were randomly divided into two groups and treated for six months with an oral contraceptive containing 0.030 mg ethinylestradiol (EE) plus 0.150 mg levonorgestrel or 0.150 mg levonorgestrel. After six months' treatment a 30% decrease in DHEA-S levels were observed in the desogestrel/EE group and a 15% decrease in the levonorgestrel/EE group; the difference was not statistically significant. At the same time serum total cortisol increased by 75-100% and free testosterone fell by 30-40% in both groups, whereas SHBG elevated 250% in the desogestrel/EE group and 30% in the levonorgestrel/EE group. Acne improved significantly in both groups, desogestrel/EE showing greater improvement. A decrease in SHBG and increase in DHEA-S levels appear to be the most common hormonal changes in acne. Oral contraceptive treatment induces an increase in SHBG and decrease in DHEA-S and also improves acne.     

Hidradenitis suppurativa—an androgen—dependent condition

Hidradenitis suppurativa (HS) is a chronic inflammatory condition of apocrine glands: poral occlusion and added bacterial infection are important aetiological factors but the underlying cause remains unknown. Published animal work shows the apocrine gland to be hormone dependent. A similar mechanism is suggested in man by the failure of HS to appear before puberty and its frequent association with acne vulgaris and other androgen-dependent conditions.
Forty-two patients with HS have been clinically and biochemically assessed for signs of increased androgen activity. Plasma total testosterone (T) sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), prolactin, FSH, LH and 17-β-oestradiol were measured and compared with groups of normal female controls (n = 25) and subjects with idiopathic hirsutes (n = 37). Nineteen patients with no medical contra-indications were randomly allocated to a double-blind within-patient crossover trial comparing ethinyloestradiol (50 μg) ^and cyproterone acetate (CPA) (50 mg in a reverse sequential regimen) with ethinyloestradiol (50 mg and levonorgestrel (500 μg) (EU/50). Treatments were sequential for 12 months with crossover at 6 months. Patients were assessed by clinical grading.
Results demonstrate total testosterone and T/SHBG (index of free testosterone) to be significantly higher than normal controls in the HS group (P < 0·01) as well as the hirsutes group (P < 0·01).
Treatment with CPA demonstrated significant improvement as compared to EU/50. Seven of the 19 patients were ultimately clear of the disease.
We propose clinical criteria, including the presence of comedones, associated acne and pilonidal sinus, for establishing the diagnosis of HS. Early recognition is important for satisfactory control of the disease.     

Assessment of androgens in women with adult-onset acne

BACKGROUND: Acne is generally recognized as a disorder of young adults; however, the referral of patients aged over 25 years with acne is increasing. Disturbed androgen production in the ovaries or adrenal gland and impaired plasma transport of androgens in women with adult-onset acne or acne associated with hirsutism have been described. METHODS: Thirty-five white women with adult-onset acne (onset after the age of 25 years) and hirsutism (A + H), 35 white women with adult acne without hirsutism (A - H), and 35 age-matched white female controls were recruited in this case-control study. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, dihydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) were determined in all patients and compared. RESULTS: The mean SHBG, free androgen index (FAI), and DHEA-S were significantly different between A + H and control subjects. The only significant difference between A - H and control subjects was observed for DHEA-S. CONCLUSION: DHEA-S plays a key role in the pathogenesis of adult-onset acne. Measurement of circulating androgens, including DHEA-S, especially in patients presenting with adult-onset acne and hirsutism, is helpful, and patients with elevated levels can benefit from hormonal therapy.