抗苗勒管激素与性激素检测对卵巢储备功能的评估价值

目的探讨抗苗勒管激素与性激素检测对卵巢储备功能的评估价值。方法回顾性分析2018年11月至2019年6月我院收治的588例成年女性患者临床资料,其中310例患者接受性激素检测,278例患者接受抗苗勒管激素检测,以临床确诊结果作为金标准,分析其诊断价值。结果抗苗勒管激素+性激素检测的敏感性、特异性、准确度分别为98.22%(166/169)、99.05%(415/419)、98.81%(581/588),高于抗苗勒管激素检测的81.97%(50/61)、94.01%(204/217)、91.37%(254/278)及性激素检测的76.85%(83/108)、91.09%(184/202)、86.13%(267/310),差异具有统计学意义(P<0.05)。结论抗苗勒管激素检测与性激素检测在卵巢储备功能评估方面均具有较高的诊断效能,但联合检测的诊断效能更高,值得推广。     

绝经期妇女激素补充治疗的新进展

女性一生中约有1/3,甚至更长的时间是在围绝经期与绝经期度过的。由于卵巢功能的逐渐衰退,造成雌激素不足,绝经后的妇女会出现一系列的身心症状,影响个人的生活质量,给家庭和社会带来巨大的压力和负担。激素补充治疗对缓解更年期综合征,减少骨质疏松和骨折,改善妇女的生活质量,减少社会和家庭的压力与负担起了很重要的作用。该文肯定了激素补充治疗(HRT)对绝经期妇女的益处多于不良作用,强调每年评估利与弊,不断总结应用HRT的特点,扬长避短,为绝经期保健提供科学的依据。     

Hormone replacement therapy - the agents

Hormone Therapy (HT) is a valid option for women with climacteric symptoms. At present there is a controversy as to whether HT should be used chronically for prevention to each patient. This review investigates the basic use of oestrogens, progestogens, the HT regimens, bleeding problems in HT users and when HT is necessary.     

Hormone Testing and Treatment Enters Pain Care

Abstract

A number of factors have recently coalesced to bring hormone testing and treatment to the field of pain care. Uncontrolled, severe pain as well as opioid drugs have a profound impact on the endocrine system. Because pain is a potent stressor, it initially causes pituitary, adrenal, and gonadal hormones to elevate in the serum. If severe pain goes uncontrolled for too long, however, hormone levels deplete in the serum. The finding of abnormal (too high or low) serum hormone levels serve as biomarker of endocrinopathies, which helps inform the clinician that enhanced analgesia as well as hormone replacement may be necessary. Adequate, physiologic levels of some specific hormones are necessary for optimal analgesia, neuroprotection, and neurogenesis. Although not a substitute for opioids, some hormone replacements may minimize their use. We know that the central nervous system produces a group of hormones called neurohormones whose natural function is neuroprotection and neurogenesis. Their clinical use in centralized pain states is new, and early reports indicate that they may have considerable benefit for treatment.     

抗苗勒管激素与男性生殖相关疾病的研究进展

抗苗勒管激素(anti-Mullerian hormone,AMH),又名苗勒管抑制素(Mullerian inhibiting substance,MIS),最早发现于男性胎儿,因抑制其苗勒管的发育而命名,对男性性分化具有重要作用。目前研究发现AMH在男性生殖相关领域有更加广泛的临床应用,主要体现在5个方面:(1)诊断两性畸形患者是否存在男性性腺,血清AMH比Y染色体敏感度更高,且是青春期评估睾丸功能较好的标志物;(2)与血清AMH水平比较,精浆AMH与睾丸生精功能显著相关,与精液质量呈正相关,是鉴别梗阻性、非梗阻性无精子症特异性较高的标志物;(3)精浆AMH是目前预测严重少、弱精子症患者精液冷冻-复苏率较好的指标;(4)精浆AMH水平可预测重组人卵泡刺激素(rh FSH)治疗特发性少、弱精子症的疗效;(5)对生育期需接受放化疗的男性肿瘤患者生育力的评估,精浆AMH是目前特异性最高的生物标志物。     

环境中的植物激素与人体健康

当前儿童性早熟发病率不断增高,怀疑与儿童食用过多的激素水果有关.研究发现,植物生长调节剂属于低毒农药,对人体的毒性主要表现在急性中毒.动物实验存在潜在的影响生殖功能和生长发育作用,但这类影响尚不能确定.新闻媒体零散的激素水果致儿童性早熟的报道,在未排除其他混杂因素如环境激素污染、遗传、误服药物、保健营养品和动物激素污染的食品等情况下,尚不能确定因果联系.建议正确面对我国大量使用植物生长调节剂的现实,谨慎地接受激素水果、蔬菜.     

Racial Differences in Physician Recommendation of Hormone Replacement Therapy

PURPOSE: Previous studies have suggested that black women may be less likely than white women to be offered and to take hormone replacement therapy (HRT). Thus, race and other factors associated with physician recommendation of HRT that may influence women's decisions about HRT were examined. METHODS: Data were from a baseline assessment of participants in a randomized controlled trial designed to evaluate the efficacy of a tailored decision-aid on HRT decision-making. We telephone interviewed 581 Durham women ages 45-54. The association of race and other factors with reported physician recommendation of HRT was tested using chi(2) and logistic regression analysis. RESULTS: Overall, 45% of women surveyed reported that their physician recommended HRT; black women were significantly less likely than white women to report being advised about HRT (35% vs. 48%, respectively, P < 0.005). Additional factors associated with being recommended HRT included older age, being postmenopausal, having had a hysterectomy, having thought about the benefits of HRT, and being satisfied with information about HRT. CONCLUSIONS: Black women are less likely than white women to receive physician recommendation of HRT. Racial differences in patient-provider communication about HRT exist and thus require greater diligence on the part of health care providers to minimize such a gap.     

卵巢早衰的性激素水平分析及临床发病率

目的:分析POF患者血清中相关性激素FSH、LH、E2、P的水平变化及临床发病率。方法:应用电化学发光免疫分析技术(ECLIA),从711名测定激素的女性中,选取临床确诊、检测结果符合诊断的POF患者23例,围绝经期患者21例进行比较。结果:POF(A组35岁以下,B组35~40岁)FSH水平均值升高,与围绝经期FSH均值(C组41~45岁)比较,P>0.0 5。A、B两组E2水平均值下降,与C组比较,P>0.05。LH、P两项激素的水平均值,A、B、C 3组之间差别不大,结果均显示LH升高,P下降。A组4项激素检测结果标准差均明显大于B、C两组。A、B两组占总数的3.2%。结论:POF患者血清中FSH、LH水平明显升高,而E2、P则相应降低。A组激素水平不稳定性较大。本组资料临床发病率3.2%,支持POF发病率有上升趋势这一观点。     

甲苯对雌性大鼠卵巢及性激素的影响

目的研究急性甲苯染毒对大鼠卵巢的病理组织学改变及性激素的影响，探讨甲苯对雌性大鼠生殖毒性作用。方法选用清洁级SD大鼠30只，按体重随机分为3组，染毒浓度0、130、1300mg／m^3，动情前期暴露甲苯2、24h后取血清和卵巢，采用放射免疫法测定血清中性激素即雌二醇和黄体酮（E2、P4），卵巢标本采用HE染色，计算卵巢中各等级卵泡的数目。结果对性激素进行比较，低浓度组E2显著低于对照组（P〈0．05），P4各组差异无统计学意义；各组间卵泡数目比较，差异无统计学意义。结论接触一定的甲苯对雌性大鼠血清中的部分性激素具有抑制作用。     

精索静脉曲张程度与激素水平的相关性研究

目的：探讨彩色多普勒检测精索静脉曲张（VC）患者静脉曲张的程度与患者血清睾酮（T）、催乳素（PRL）、黄体生成素（LH）、雌二醇（E2）、卵泡刺激素（FSH）五种生殖激素水平的相关性。方法：采用电化学免疫发光法，分别对186例不同程度的精索静脉曲张患者（A组62例、B组70例、C组54例）以及60例能正常生育且排除精索静脉曲张的患者（D组）的外周血以上五种生殖激素的水平进行检测。结果：随着精索静脉曲张程度的加重，FSH和E2水平呈逐渐升高趋势，C组FSH水平[（8．81±3．74）IU／L]与D组[（6．73±2．25）IU/L比较，C组E2水平[（52．32±6．17）ng／L]与D组[（38．62±4．08）ng／L]比较，差异均有统计学意义（P〈0．05）。LH、PRL、T3种生殖激素A、B、C组与D组比较差异均无统计学意义（P〉0．05）。结论：精索静脉曲张程度与FSH和E2水平呈正相关。生殖激素水平对反映精索静脉曲张所致睾丸病理生理变化有一定的参考价值。