垂体瘤术前后垂体性腺轴功能的评估和替代治疗

促性腺激素减低性性腺功能减退是垂体瘤患者最常见的内分泌功能改变．它影响患者的性征和生育能力。合理治疗性腺轴功能低下可预防和改善患者在代谢综合征、心脑血管事件、骨质疏松、精神心理、生活质量等方面的问题．但目前对其评估和治疗的重视度远远不够。本文详细综述了男性和女性性腺轴的评估内容，包括临床表现、性腺激素测定、促性腺激素释放激素激发试验等方面的新的进展：明确了有性腺功能减退的患者根据是否有生育的需求选择不同的治疗方法，尤其是详细介绍了睾酮替代治疗：以及术后需重新评估和定期随访及制订个体化治疗方案的重要性．

The Assessment and Replacement of the Hypothalamus-pituitary-gonads Axis before and after the Pituitary Tumor Surgery

Hypogonadotropic hypogonadism is the most common dysfunction in the pituitary tumor. It impacted the sex characters and fertility. Proper treatment can prevent or improve the metabolic syndrome, cardiovascular and cerebrovaseular events, osteoporosis, psychologic and quality of life. However, insufficient notice was on the axis. We reviewed the new ideas at the assessment of the hypothalamus-pituitary-gonadal axis for male and female, including the clinical features, hormone measurements and other laboratory work-ups. The therapies for the hypogonadotropic hypogonadism should be determined based on the patient＇s desire for future fertility. We gave a detailed introduction for the testosterone replacement. Reassessment, follow-up and individualized treatment was noted.