急性脑外伤患者垂体—性腺轴的功能变化（论著摘要）

测定57例急性脑外伤和31例正常对照者的血清催乳素(PRL)、卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、孕酮(P)和睾酮(T)6项指标，分析脑外伤急性期患者的促性腺激素和性激素水平改变，探讨其临床意义。     

男性痴呆患者血清性激素的变化

目的:观察阿尔茨海默病(AD)和血管性痴呆(VD)男性患者血清性激素及促性腺激素的变化。方法:老年男性共114人,其中AD 3 2例;VD 3 0例;无痴呆正常老年人5 2名。采用化学发光法测定血中黄体生成素(LH )、促卵泡成熟素(FSH)、雌二醇(E2 )、催乳素(PRL)、睾酮(T)的含量,并计算E2 /T的比值。结果:AD组及VD组患者血清T水平较正常对照组低,差别有显著意义(P <0 .0 5 ,P <0 .0 1)。VD组患者血清E2 /T较正常对照组显著升高;也较AD组明显升高(P <0 .0 1,P <0 .0 5 )。AD、VD组患者血清E2 、LH、FSH、PRL与正常对照组比较,差别均无显著意义(P >0 .0 5 )。结论:老年男性AD及VD患者血清T水平降低。     

精神分裂症患者性激素与认知功能的关系

目的:探讨精神分裂症患者性激素与认知功能的关系。方法:精神分裂症患者95例,使用利培酮治疗6周,分别于治疗前和治疗后进行雌二醇(E2)、孕酮(Prog)、睾酮(T)、催乳素(PRL)、促卵泡激素(FSH)、黄体生成素(LH)检测、简明精神病评定量表(BPRS)评定和瑞文标准推理测验。结果:男性患者的E2、T、FSH、LH水平与瑞文测验正确题数、知觉辨别、类同比较、比较推理、系列关系正确题数均正相关;治疗后E2、T水平不再与瑞文推理测验相关。女性患者的E2、Prog、T、FSH、LH水平与瑞文测验正确题数、智商数、类同比较、比较推理、系列关系、抽象推理正确题数均正相关;治疗后E2、LH水平仍与瑞文测验正确题数、智商数、类同比较、比较推理、系列关系、抽象推理正确题数正相关,T水平与瑞文测验正确题数及所有因子正确题数负相关。结论:男女精神分裂症患者性激素对认知功能有不同影响。     

复合蛋白锌对伴有性障碍的精神分裂症患者性激素影响

测定40例男性及20例女性伴有性障碍的精神分裂症患者血清性激素的含量,并比较服用复合蛋白锌后其激素水平的动态变化。结果表明,本组男性患者雌二醇(E_2)含量为226.26±284.45pg/ml,女性患者睾丸酮(T)含量172.7±190.55ng/ml。与正常人相比,构显著高于正常值(P<0.05),雌/雄比值倒置。泌乳素(PRL)含量,男、57.2±14.46mg/ml。女,56.38±60.72mg/ml,虽较正常值高,但无统计差异。锌治疗后,上述三种性激素水平恢复正常。治疗前后比较,差异显著,其中男性患者PRL含量差异极显著(P<0.01),而其余性激素FSH(促卵胞激素),及LH(黄体生成素)的水平均在正常范围内,锌对其影响不著。     

万拉法新与帕罗西汀治疗抑郁症对照研究

目的 比较万拉法新和帕罗西汀治疗抑郁症的疗效和不良反应。方法 将132例符合CCMD一2一R抑郁症诊断标准的患随机分成两组，分别给予万拉法新和帕罗西汀治疗，于治疗前和治疗后l、2、6周末分别用汉密尔顿抑郁量表[HAMD]和副反应量表[TESS]评定。结果 万拉法新的痊愈率、显效率均与帕罗西汀相似。HAMD评分6周末两组无显差并，l周末时万拉法新组显低与帕罗西汀组(P＜0．01)。两组不良反应发生率均低而轻微。结论 万拉法新治疗抑郁症疗效肯定，见效快，不良反应轻微。     

心境障碍与下丘脑-垂体-性腺轴的关系

目的:探讨心境障碍与下丘脑-垂体-性腺轴的关系. 方法:对136例心境障碍患者(抑郁组66例,躁狂组70例)以及与之性别、年龄匹配的正常对照者66人进行血清催乳素(PRL)、雌二醇(E2)、睾酮(T)、促卵泡刺激素(FSH)、促黄体生成素(LH)、孕酮(PRG)水平检测并比较. 结果:与正常对照组比较,抑郁组血清PRL水平显著升高(P＜0.05);躁狂组血清PRL、T、E2、LH、PRG水平显著升高(P均＜0.05). 结论:心境障碍患者存在下丘脑-垂体-性腺轴功能紊乱.     

服用抗癫痫药的患者垂体—性腺轴的变化

目的了解服抗癫癎药物(AEDs)患者垂体-性腺轴的变化.方法用化学发光法检测40例癫癎患者和38例健康对照组的血浆PRL、LH、FSH、Tes、E2及PG,并比较首次癫癎发作(NAEDs)组与AEDs组的血浆性激素的变化.结果NAEDs组男性LH降低(P＜0.01),Tes降低(P＜0.05),和E2降低(P＜0.01),女性Tes降低(P＜0.01),E2降低(P＜0.005),和PG降低(P＜0.05).AEDs组男性PRL升高(P＜0.05),女性LH增高(P＜0.05).结论癫癎患者存在性激素平衡失调,AEDs可能主要影响垂体分泌.     

血清性激素、5-HT水平与围绝经期妇女抑郁焦虑的关系

目的探讨血清性激素、5-羟色胺(5-HT)水平与围绝经期妇女抑郁焦虑的关系。方法2015年4月至2016年4月选取180例无躯体器质性病变及其它精神障碍疾病的围绝经期妇女为调查研究对象,根据焦虑自评量表(SAS)及抑郁自评量表(SDS)将调查对象分为对照组(n=54),抑郁组(n=38),焦虑组(n=42)及抑郁焦虑共病组(n=46),测定各组血清中雌二醇(E2)、孕酮(P)、垂体催乳素(PRL)、卵泡生成素(FSH)、睾酮(T)及黄体生成素(LH)、5-羟色胺(5-HT)水平。结果四组血清FSH、LH、PRL水平比较无统计学差异(P0.05),四组血清E2、P、T、5-HT水平比较有统计学差异(P0.05)。经Pearson相关系数分析,围绝经期妇女血清P与SDS评分、SAS评分呈负相关(P0.05),血清T与SDS评分、SAS评分呈正相关(P0.05),血清5-HT与SDS呈正相关(P0.05)。结论性激素与围绝经期抑郁焦虑的发生有密切的关系,5-HT可与性激素共同影响抑郁症的发生。     

服用抗癫癇药的患者垂体性腺轴的变化

目的 :了解服抗癫药物 (AEDs)患者垂体 性腺轴的变化。方法 :用化学发光法检测 40例癫患者和 3 8例健康对照组的血浆PRL、LH、FSH、Tes、E2 及PG ,并比较首次癫发作 (NAEDs)组与AEDs组的血浆性激素的变化。结果 :NAEDs组男性LH降低 (P <0 0 1) ,Tes降低 (P <0 0 5 ) ,和E2 降低 (P <0 0 1) ,女性Tes降低 (P <0 0 1) ,E2 降低 (P <0 0 0 5 ) ,和PG降低 (P <0 0 5 )。AEDs组男性PRL升高 (P <0 0 5 ) ,女性LH增高 (P <0 0 5 )。结论 :癫患者存在性激素平衡失调 ,AEDs可能主要影响垂体分泌     

抗精神病药对男性精神分裂症患者垂体-性腺轴的影响

目的:研究氯丙嗪、利培酮、奎硫平及奥氮平对男性精神分裂症患者垂体性腺轴的影响。方法:88例首发男性精神分裂症患者随机分为氯丙嗪组、利培酮组、奎硫平组及奥氮平组,检测治疗前、治疗4周及8周血清促卵泡素(FSH)、黄体生成素(LH)、催乳素(PRL)、睾酮(T)的水平变化。结果:氯丙嗪组治疗8周后,血清PRL水平显著高于治疗前。利培酮组在治疗4周及8周后PRL水平均显著高于治疗前,治疗8周后T及LH水平显著低于治疗前。奎硫平组在治疗4周及8周后血清PRL、LH、T水平与治疗前比较差异均无显著性。奥氮平组治疗4周后PRL水平显著高于治疗前,治疗8周后即与治疗前差异无显著性。结论:奎硫平对垂体性腺轴激素水平无明显影响。     

抑郁症患者的性激素分析

目的　研究抑郁症患者垂体促性腺激素及外周性激素的功能状态,探讨性激素水平改变与性有关症状和药物治疗的关系。方法　采用放射免疫法测定３０ 例（ 男１１ 例,女１９ 例） 抑郁症患者血清促卵泡激素（ Ｆ Ｓ Ｈ） 、黄体生成素（ Ｌ Ｈ） 、催乳素（ Ｐ Ｒ Ｌ） 、睾丸酮（ Ｔ） 、雌二醇（ Ｅ２） 等激素水平,并与２０ 例（ 男女各１０ 例） 正常人对照。结果　试验组男性 Ｌ Ｈ 和女性 Ｆ Ｓ Ｈ、 Ｒ Ｐ Ｌ 明显高于对照组,其他性激素水平两组间无显著性差异。药物治疗前后男性患者 Ｐ Ｒ Ｌ、 Ｔ、 Ｅ２ ,女患者 Ｐ Ｒ Ｌ、 Ｔ 等激素分泌改变非常显著。结论　提示抑郁症患者性腺轴存在功能失调。性有关症状与性激素水平改变无关。抗抑郁治疗可导致性激素分泌紊乱。     

Effects of Carbamazepine Therapy on Serum Sex Hormone Levels in Male Patients with Epilepsy

The effects of carbamazepine (CBZ) therapy and epilepsy on sex hormone plasma levels in male patients with epilepsy were evaluated by measuring the levels of testosterone (T), free testosterone (FT), sex hormone binding globulin (SHBG), estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and dehydroepiandrosterone sulfate (DHEAS) and by calculating the free androgen index (FAI) in 23 male patients with epilepsy receiving CBZ medication, in 18 untreated male patients with epilepsy, and in 19 healthy age-matched control subjects. No significant differences in the mean T or FT levels were found between the three groups, but the CBZ-treated patients had significantly higher SHBG levels and their FAI values and DHEAS concentrations were lower. The LH, FSH, PRL, or E2 levels in CBZ-treated and untreated male patients with epilepsy did not differ from the controls. CBZ monotherapy does not significantly change the serum balance of sex hormones; however, CBZ clearly affects the serum levels of SHBG and DHEAS.     

Effects of Carbamazepine on the Hypothalamic-Pituitary-Gonadal Axis in Male Patients with Epilepsy: A Prospective Study

The effects of carbamazepine (CBZ) monotherapy on serum sex hormone levels and on pituitary responsiveness to various stimuli were evaluated in a prospective study with 21 male patients with epilepsy. The serum levels of testosterone (T), free testosterone (FT), sex hormone binding globulin (SHBG), estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and dehydroepiandrosterone sulfate (DHEAS) were assayed, and the free androgen index (FAI) values were calculated for each patient before and after 2-month CBZ treatment. The pituitary PRL, LH, and FSH responses to luteinizing hormone-releasing hormone (LH-RH), thyrotropin-releasing hormone (TRH), and metoclopramide (MC) were also measured before and after CBZ treatment. The baseline serum hormone and SHBG levels were measured and the FAI values calculated in 16 healthy male control subjects of similar age. The mean E2 level was higher in patients before CBZ treatment than in control subjects, and untreated patients had greater variances for FAI values, PRL levels, and LH levels than control subjects. No other significant differences were found between untreated patients and control subjects. The FAI values and DHEAS levels of patients decreased during 2-month treatment with CBZ. The PRL response to MC was higher after CBZ treatment than before. The baseline levels of other hormones and SHBG, as well as the LH and FSH responses to LH-RH, remained unaltered. The results indicate that during the first 2 months of CBZ treatment the androgen balance in male epileptic patients changes: Serum DHEAS levels and FAI values decrease, although FT levels remain unchanged. The clinical relevance of these hormonal changes is obscure.     

成年男性癫痫患者血清性腺激素水平的变化

目的： 探讨癫痫发作和ＡＥＤｓ 治疗对垂体一性腺激素平衡的影响。方法： 利用ＲＩＡ法测定了诊断明确的７３ 例成年男性癫痫患者血清ＬＨ、ＦＳＨ、Ｐ、Ｅ２、Ｔ水平, 并比较了ＡＥＤｓ 治疗组与未治疗组和健康对照组病人的血清性腺激素水平。同时,观察了其中的３１ 例癫痫患者癫痫发作前后血清性腺激素水平的变化。结果：癫痫发作前后血清性腺激素水平无明显差异。ＡＥＤｓ 明显影响血清性腺激素水平。在所有ＡＥＤｓ 治疗中, 血清Ｅ２ 水平明显升高, ＬＨ水平明显减低, Ｔ／Ｅ２ 的比较明显低于正常对照和病人对照组, 在ＡＥＤｓ 单一和联合治疗组中有３９．７％ 的病例性功能低下。结论： 癫痫发作不影响血清性腺激素水平。ＡＥＤｓ明显影响性激素平衡和性功能     

精神疾病患者血清睾酮和雌二醇水平研究

目的：了解首发精神分裂症和情感性精神障碍患者血清睾酮和雌二醇的变化。方法：以放射免疫法对首次发病的５４例精神分裂症患者和３７例情感性精神障碍患者血清中睾酮和雌二醇进行测定,并与正常健康者作对照。结果：男性精神分裂症患者者血清雌 二醇浓度显著高于对照组男性,女性情感性精神障碍患者血清睾酮浓度显著高于对照组和精神分裂症组女性。治疗后女性患者血清雌二醇浓度显著下降,对睾酮浓度影响不大。结论：精神分裂症和     

Serum Steroid Hormones and Pituitary Function in Female Epileptic Patients During Carbamazepine Therapy

Ten regularly menstruating women with epilepsy were studied in a 12-month prospective follow-up study to evaluate the short-term effects of carbamazepine (CBZ) on serum sex hormone balance and pituitary function. Thirteen female epilepsy patients receiving long-term CBZ monotherapy (mean medication duration 5.3 years) were also studied. Controls were 17 regularly menstruating healthy volunteers. Untreated patients had higher free testosterone (FT) and luteinizing hormone (LH) serum concentrations than control subjects, whereas the other parameters did not differ between these two groups. However, serum sex hormone binding globulin (SHBG) levels increased and dehydroepiandrosterone sulfate (DHEAS) levels decreased during CBZ treatment. Although calculated free androgen index (FAI) decreased during CBZ therapy, the directly measured FT levels remained unaltered. These changes were found after 2 months and continued after 12 months of CBZ treatment. Moreover, patients with long-term CBZ also had high SHBG levels, low serum DHEAS levels, and low FAI values. Basal LH serum levels decreased during the first year of CBZ treatment and luteinizing hormone-releasing hormone (LH-RH)-stimulated LH concentrations were lower after 2 months of CBZ treatment. Although the serum basal follicle-stimulating hormone (FSH) and prolactin (PRL) levels were unaffected during the first year of CBZ therapy, the LH-RH-stimulated FSH concentrations and metoclopramide (MC)-stimulated PRL concentrations were lower after 12 months of CBZ treatment than before CBZ. Both basal and stimulated gonadotropin and PRL serum levels of long-term CBZ patients were unaffected. No changes were found in estradiol (E2), testosterone (T), or cortisol (C) serum concentrations during short or long-term CBZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Neuroendocrine aspects of primary endogenous depression VIII. Pituitary-gonadal axis activity in male patients and matched control subjects

To determine the extent of hypothalamo-pituitary-gonadal (HPG) axis dysfunction in endogenous depressed men, we measured nocturnal and diurnal serum luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), and estradiol (E2) concentrations, and their responses to gonadotropin releasing hormone (LHRH) and dexamethasone administration, in 16 Research Diagnostic Criteria primary, definite endogenous male depressives and 16 individually matched male normal controls. Compared to their controls, the patients showed no differences in basal nocturnal or diurnal gonadotropin or gonadal steroid hormone concentrations, and no differences in hormone concentrations either post-LHRH or post-dexamethasone. Age was negatively correlated with baseline serum T in the patients but not in the controls, and it was modestly positively correlated with baseline serum LH in both groups of subjects. In the patients, the presence of DSM-III melancholia was modestly negatively correlated with baseline and post-LHRH concentrations of both LH and FSH and was positively correlated with baseline serum T, but it bore no relation to serum E2. None of the other subject characteristics or specific dimensions of depressive symptomatology were significantly related to the HPG axis measures. The HPG axis measures also were unrelated to pre- and post-dexamethasone cortisol concentrations in both groups of subjects. The results of this study suggest that, in contrast to the hypothalamo-pituitary-adrenal cortical and thyroid axis abnormalities frequently found in endogenous depressives, HPG axis function in male depressives is relatively normal.