PCOS患者血浆leptin和血清T、E2、FSH、LH、PRL检测的临床意义

目的：探讨多囊卵巢综合征（PCOS）患者血浆leptin和血清T、E2、FSH、LH、PRL水平的变化及临床意义。方法：应用放射免疫分析和发光法对31例PCOS患者进行了血浆leptin和血清T、E2、FSH、LH、PRL测定,并以正常妇女作对照。结果：PCOS患者血浆leptin和血清T、LH、PRL水平非常显著地高于正常妇女组（P〈0.01）,FSH、E2水平与正常妇女组比较无显著性差异（P〉0.05）,且血浆leptin水平与血清T、LH、PRL水平呈正相关（r=0.5784、0.5411、0.6082,P〈0.01）。结论：检测PCOS患者血浆leptin和血清T、E2、FSH、LH、PRL水平的变化与疾病的发生和发展密切相关。     

血清AFP、β-HCG含量变化在妊娠晚期妇女中的意义分析

为观察妊娠晚期妇女血清AFP(甲胎蛋白)、β-HCG(β-人绒毛膜促性腺激素)含量变化的意义,本文对64例妊娠晚期妇女进行血清AFP、β-HCG测定,现报告如下。1材料和方法1.1材料1.1.1正常人42名,均为我院健康体检的育龄妇女(无肝胆疾患,HBsAg阴性),年龄(19～43)岁。1.1.2妊娠晚期妇女     

血清孕酮、β-HCG检测在异位妊娠早期诊断中的作用

目的　探讨血清孕酮、β -HCG在早期诊断异位妊娠中的价值 . 方法　对 14 0例疑诊异位妊娠病人的血清孕酮、β -HCG水平进行监测 ,根据妊娠结局分为 3组 :异位妊娠组、先兆流产组、难免流产组 .结果　异位妊娠组血清孕酮值显著低于其它两组 (p <0 .0 5 ) .异位妊娠组β -HCG值与先兆流产组有差异 (p <0 .0 5 ) ,但与难免流产组间无差异 (p>0 .0 5 ) .以孕酮值 32 .5nmol/L区分异位妊娠与先兆流产敏感性、特异性、准确性分别为 89.2 %、10 0 %、94 .9% .以 2 3.8nmol/L区分异位妊娠与难免流产的敏感性、特异性、准确性分别为 87.3%、86 .8%、89.6 % .以 4 7.5nmol/L区分异常妊娠 (异位妊娠及难免流产 )与先兆流产 ,敏感性、特异性、准确性分别为 84 .7%、93.5 %、87.4 % . 4 8h后血清 β-HCG值上升幅度≥ 5 0 %者中 ,仅 10 .3%为异位妊娠 ,89.7%为先兆流产 ;在下降幅度≥ 5 0 %者中 ,82 .8%为难免流产 ,17.2 %为异位妊娠 .结论　血清孕酮检测简便、快捷 ,可作为一种早期诊断异位妊娠的手段 ,推荐 <4 7.5nmol/L为诊刮的指标 .间隔 4 8h测定β -HCG值观察其上升或下降幅度对异位妊娠的鉴别诊断有一定意义     

血清β-HCG在计划生育的药物流产中的临床意义

目的:探讨检测血清β-HCG在计划生育药流中的临床意义。方法:采用化学发光法测定254例正常妊娠和102例异位妊娠育龄妇女血清人绒毛膜促性腺激素(HCG)。结果:检测血清β-HCG的含量,正常妊娠组的值明显大于异位妊娠组,差异显著(P<0.01)。检测的结果还提示,β-HCG的值越大,孕囊排出体外的时间越长,而B超的结果则与孕囊排出体外的时间关系不大,无显著性差异(P>0.05)。结论:对正常妊娠做药物流产的育龄妇女,停经天数超过45d,血清β-HCG的值>50000m IU/m l的患者,可适当加服米索,以便使孕囊尽早排出体外。     

血清孕酮、β-HCG检测在异位妊娠早期诊断中的作用

目的探讨血清孕酮、β-HCG在早期诊断异位妊娠中的价值.方法对140例疑诊异位妊娠病人的血清孕酮、β-HCG水平进行监测,根据妊娠结局分为3组:异位妊娠组、先兆流产组、难免流产组.结果异位妊娠组血清孕酮值显著低于其它两组(p<0.05).异位妊娠组β-HCG值与先兆流产组有差异(p<0.05),但与难免流产组间无差异(p>0.05).以孕酮值32.5nmol/L区分异位妊娠与先兆流产敏感性、特异性、准确性分别为89.2%、100%、94.9%.以23.8nmol/L区分异位妊娠与难免流产的敏感性、特异性、准确性分别为87.3%、86.8%、89.6%.以47.5nmol/L区分异常妊娠(异位妊娠及难免流产)与先兆流产,敏感性、特异性、准确性分别为84.7%、93.5%、87.4%.48h后血清β-HCG值上升幅度≥50%者中,仅10.3%为异位妊娠,89.7%为先兆流产;在下降幅度≥50%者中,82.8%为难免流产,17.2%为异位妊娠.结论血清孕酮检测简便、快捷,可作为一种早期诊断异位妊娠的手段,推荐<47.5nmol/L为诊刮的指标.间隔48h测定β-HCG值观察其上升或下降幅度对异位妊娠的鉴别诊断有一定意义.     

GnRH-A促进雌兔FSH与LH分泌及卵巢发育的作用

目的探讨GnRH类似物(GnRH-A)对FSH与LH分泌及卵巢发育的影响,及GnRH-A调节生育的机制。方法 24只雌兔均分为实验Ⅰ组(EG-Ⅰ)、Ⅱ组(EG-Ⅱ)、Ⅲ组(EG-Ⅲ)和对照组(CG)(n=6),实验组分别于颈背侧皮下注射0.1、0.1和0.05 g/L GnRH-A抗原1.0 mL,EG-Ⅱ和EG-Ⅲ组于20 d加强注射1次。ELISA法测定血清FSH和LH含量。于70 d无菌切取卵巢,光镜和电镜观察。结果 40 d时EG-Ⅱ和EG-Ⅲ组血清FSH和LH浓度均达到峰值,明显高于EG-Ⅰ和CG组的FSH和LH(P<0.01),且EG-Ⅱ组高于EG-Ⅲ组(P<0.05)。EG-Ⅱ组和EG-Ⅲ组卵巢皮质变厚,卵泡纵径和横径均增大,且与剂量相关。实验组卵巢卵泡数增加,生长加快。细胞核、线粒体和线粒体嵴变大,细胞质中的皮质颗粒和分泌物增多,透明带和微绒毛变大。结论 GnRH-A能促进FSH和LH的合成及卵巢与卵泡的发育,加强注射效果更明显。     

异位妊娠患者血清β-HCG、孕酮及抑制素-A水平变化及其临床意义

异位妊娠（ectopic pregnancy,EP）是指受精卵在子宫体腔以外着床,是妇产科常见的急腹症,近年来患病率呈明显上升趋势。目前,EP的早期诊断主要依靠阴道超声检查和β-人绒毛膜促性腺激素（β-HCG）的检测[1],但对于妊娠早期的孕妇,即使提高阴道超声的分辨率,     

男性不育症患者血清IL-6、T、LH、FSH、PRL检测的临床意义

目的：探讨了男性不育症患者血清IL-6、T、LH、FSH和PRL水平的变化及临床意义。方法：应用放射免疫分析对68例男性不育症患者进行了血清IL-6、T、LH、FSH和PRL检测,并与35名男性正常人作比较。结果：男性不育症患者血清T水平非常显著地低于男性正常人组（P〈0.01）,而IL-6、FSH、LH和PRL水平又非常显著地高于男性正常人组（P〈0.01）。血清IL-6水平与T水平呈负相关（r=-0.4186,P〈0.01,与FSH、LH和PRL水平呈正相关（r=0.6018、0.5912、0.6214,P〈0.01）。结论：检测男性不育症患者血清IL-6、T、LH、FSH和PRL水平的变化对诊断、预后判断及治疗均有较大的实用价值。     

福州地区正常孕妇妊娠期标准化尿HCG、β-HCG变化曲线

绘制福州地区正常孕妇妊娠期＂标准化＂尿HCG、β-HCG变化曲线图。对180名正常孕妇妊娠540周的尿液,用R IA法检测尿HCG、β-HCG,用酶法检测尿肌酐并计算各孕周经尿肌酐校正后的标准化尿HCG、β-HCG值,并绘制HCG、β-HCG变化曲线。结果表明福州地区正常孕妇妊娠期标准化尿HCG、β-HCG变化曲线的拟合相关系数分别为0.628和0.702,拟合有意义（P〈0.05）。本文正常孕妇妊娠期标准化尿HCG、β-HCG整体变化曲线、血清和尿HCG的变化都与文献报道基本一致。     

血清β-HCG和孕酮联检在早期异位妊娠的临床应用

异位妊娠(ectopic pregnancy,EP)是妇产科的常见病与多发病,近年来其发病率逐年上升,临床上对于早期或无特征的病例有时难以及时确诊。在与妊娠相关的死亡中,由异位妊娠引起的占了9%[1]。血清β-人绒毛膜促性腺激素(β-HCG)和孕酮的检测为临床妇科疾病,特别是急腹症的患者在诊断、治疗以及疗效观察上提供了重要参考价值[2]。本文对40例异位妊娠患者与50例同期健康妊娠妇女血清β-HCG和孕酮进行联检,现将结果报道如下。     

The role of LH and FSH in ovarian androgen secretion and ovarian follicular development: clinical studies in a patient with isolated FSH deficiency and multicystic ovaries.

Inactivating mutations have proven to be instructive in elucidating the role of FSH in human ovarian function. We performed a detailed reproductive endocrine evaluation of a patient with inactivating mutations in the FSH beta-subunit gene who was hypo-estrogenic and had LH excess. The patient underwent a pelvic ultrasound and overnight frequent blood sampling followed by a human chorionic gonadotrophin (HCG) stimulation test. One month later she received human recombinant FSH, followed 24 h later by a second HCG stimulation test. Despite a mean LH serum concentration and LH pulse characteristics typical for polycystic ovaries (PCOS), baseline and dexamethasone-suppressed free testosterone were low-normal. The administration of HCG led to minimal stimulation of 17-hydroxyprogesterone and androgens. The patient had multicystic ovaries containing follicles 3-5 mm in diameter and responded to FSH with prompt increases in estradiol and inhibin B. There were no clinical or laboratory consequences of LH excess in this FSH-deficient woman. These findings support the hypothesis that excessive LH stimulation alone does not cause ovarian hyperandrogenism. We also found that follicular development was present in the absence of FSH. These antral follicles had apparently developed normally, since estradiol and inhibin B increased promptly after FSH administration.     

LH serum levels during ovarian stimulation as predictors of ovarian response and assisted reproduction outcome in down-regulated women stimulated with recombinant FSH

BACKGROUND: There has been much debate about the effect of 'residual' LH levels in normogonadotrophic women undergoing assisted reproduction with GnRH agonist down-regulation and recombinant FSH ovarian stimulation. The aim of this prospective study, where receiver-operating characteristic (ROC) analysis was used, was to assess further the usefulness of serum LH levels as predictors of ovarian response, assisted reproduction treatment outcome, and the outcome of pregnancy when measured throughout the ovarian stimulation period in a large cohort of such assisted reproduction treatment women. METHODS: A total of 246 consecutive women undergoing their first cycle of IVF or ICSI treatment were included in this study. Blood samples for hormone analyses were obtained on day S0 (the day when pituitary suppression was evidenced) and every other day from stimulation day 5 (S5) until the day of hCG injection. RESULTS: LH serum levels throughout ovarian stimulation treatment were similar for cancelled (n =32) versus non-cancelled (n = 214) cycles, non-conception (n = 132) versus conception (n = 82) cycles, and ongoing pregnancy (n = 66) versus early pregnancy loss (n = 16) groups. There was no correlation between LH serum levels in non-cancelled cycles and parameters of ovarian response and assisted reproduction treatment outcome. ROC analysis showed that serum LH concentration during ovarian stimulation was unable to discriminate between cancelled and non-cancelled cycles, conception versus non-conception cycles, or early pregnancy loss versus ongoing pregnancy groups. CONCLUSIONS: Serum LH measurements during ovarian stimulation with recombinant FSH under pituitary suppression in normogonadotrophic women undergoing assisted reproduction treatment cannot predict ovarian response, IVF/ICSI outcome, implantation, and the outcome of pregnancy. Thus, there is little underlying physiological support for the addition of LH in stimulation protocols if daily doses of an appropriate GnRH agonist (leuprolide or triptorelin having lower potency than buserelin) and a step-down regimen of recombinant FSH administration are used.     

Suppression of LH during ovarian stimulation: analysing threshold values and effects on ovarian response and the outcome of assisted reproduction in down-regulated women stimulated with recombinant FSH

BACKGROUND: It has been recently suggested that gonadotrophin-releasing hormone agonist down-regulation in some normogonadotrophic women may result in profound suppression of LH concentrations, impairing adequate oestradiol synthesis and IVF and pregnancy outcome. The aims of this study, where receiver-operating characteristic (ROC) analysis was used, were: (i) to assess the usefulness of serum LH measurement on stimulation day 7 (S7) as a predictor of ovarian response, IVF outcome, implantation, and the outcome of pregnancy in patients treated with recombinant FSH under pituitary suppression; and (ii) to define the best threshold value, if any, to discriminate between women with 'low' or 'normal' LH concentrations. METHODS: A total of 144 infertile women undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment were included. Seventy-two consecutive patients having a positive pregnancy test (including 58 ongoing pregnancies and 14 early pregnancy losses) were initially selected. As a control non-pregnant group, the next non-conception IVF/ICSI cycle after each conceptual cycle in our assisted reproduction programme was used. RESULTS: The median and range of LH values in non-conception cycles, conception cycles, ongoing pregnancies, and early pregnancy losses, clearly overlapped. ROC analysis showed that serum LH concentration on S7 was unable to discriminate between conception and non-conception cycles (AUC(ROC) = 0.52; 95% CI: 0.44 to 0.61) or ongoing pregnancy versus early pregnancy loss groups (AUC(ROC) = 0.59; 95% CI: 0.46 to 0.70). To assess further the potential impact of suppressed concentrations of circulating LH during ovarian stimulation on the outcome of IVF/ICSI treatment, the three threshold values of mid-follicular serum LH proposed in the literature (<1, < or =0.7, <0.5 IU/l) to discriminate between women with 'low' or 'normal' LH were applied to our study population. No significant differences were found with respect to ovarian response, IVF/ICSI outcome, implantation, and the outcome of pregnancy between 'low' and 'normal' S7 LH women as defined by those threshold values. CONCLUSIONS: Our results do not support the need for additional exogenous LH supplementation in down-regulated women receiving a recombinant FSH-only preparation.     

新疆不同民族孕妇血清CG水平的监测及其临床意义

探讨新疆不同民族孕妇血清甘胆酸 (CG)对妊娠期肝内胆汁郁积症 (ICP)的临床诊断价值。用放射免疫法检测正常少数民族及汉族孕妇和少数民族、汉族孕妇ICP患者血清CG及丙氨酸转氨酶 (ALT) ,并进行对比分析。结果显示 :正常妊娠中期少数民族、汉族孕妇CG含量无显著差异 (P >0 .0 5 ) ;正常妊娠晚期少数民族孕妇CG含量明显高于汉族孕妇 ,差异显著 (P <0 .0 5 ) ;不同民族ICP患者组CG含量和ALT水平均明显高于正常妊娠中、晚期组 ,有显著差异 (P <0 .0 1 ) ,少数民族ICP组CG含量和ALT水平均明显高于汉族ICP组 (P <0 .0 1 )。结论 :应将血清CG测定作为孕妇的常规检查 ,这对及时诊断和治疗ICP极为重要 ,同样要重视少数民族孕妇CG水平的监测 ,加强少数民族孕妇围产期的保健工作。     

深圳特区已婚育龄妇女的生活质量及其影响因素

目的：对深圳特区已婚育龄妇女的生活质量及其影响因素进行研究。方法：从深圳市南山区采取１０％户籍人口作为调查对象,测评其生活质量、人格和应付方式,并进行有关的统计分析。结果：发现被调查家庭的妇女中,农转非居民文化程度较低、职业以个体经商、待业者为多。家庭中已有的小孩数多、家务劳动量大,参加娱乐活动较少。农转非居民还存在对社会支持的利用较少、积极应付方式使用较低和较高的神经质倾向;客观生活质量方面,农转非居住房面积较大,环境好;而原城市居民收入较高,生活更加便利。但是在主观生活满意度上,两组没有差别。相关分析发现,主观生活满意度是一综合性指标,与客观外界环境、个性修养、应付方式和社会支持、闲暇活动等社会资源的利用有关。结论：特区已婚育龄妇女的客观生活质量,依人口来源而有所不同。而主观生活质量则依生活环境、人格、应付方式和社会支持因素综合决定。     

特发性中枢性早熟女孩血清E2、FSH、LH变化与子宫和卵巢形态改变关系的探讨

目的通过血清E2、FSH、LH测定及子宫和卵巢形态改变关系的研究,探讨特发性中枢性性早熟女孩的特点.方法分析了67例特发性中枢性性早熟女孩血清E2、FSH、LH的变化及子宫和卵巢B超形态学改变,并进行直线相关分析.结果(1)不同型卵巢的血清LH和E2值差异有显著性(p＜0.01)且呈递增趋势.FSH在三组间无规律性改变.(2)子宫大小随成熟度增高而显著增大,子宫容积与血清LH、E2之间显著相关(p＜0.002,0.001).(3)卵巢容积随发育分期增大,容积与血清LH、FSH、E2均不相关.结论(1)血清LH和E2的水平与最大卵泡直径相关,而与总容积不相关,但最大卵泡直径与LH、E2及卵巢总容积显著相关,从而证实了LH与卵泡发育的关系及E2的水平主要取决于卵泡发育状态.(2)子宫体容积与LH、E2均相关,子宫的发育呈显著的雌激素依赖性.E2与子宫发育间有密切关系.(3)血清E2、LH、FSH测定及子宫和卵巢形态学检查综合判断有助于对中枢性性早熟作出诊断.     

冲突策略量表(中文简版)在流动育龄妇女中应用的信效度

目的评价冲突策略量表(中文简版)在流动育龄妇女中应用的信度和效度。方法采用便利抽样的方法在广州市白云区抽取1003例流动育龄妇女接受中文简版冲突策略量表的调查。结果中文简版冲突策略量表条目-总分相关系数在0.18~0.64之间(P0.01),内部一致性Cronbach'sα系数为0.91,Guttman系数为0.74。其中,协商、心理攻击、躯体暴力、强迫性性行为、伤害各分量表的Cronbach'sα系数依次为:0.77、0.72、0.88、0.93、0.84;Guttman系数依次为:0.64、0.46、0.83、0.89、0.62。经探索性因子分析提取5个公因子,可以累计解释73.34%的方差。结论中文简版冲突策略量表具有良好的信度和效度,可以稳定测量我国流动育龄妇女亲密伴侣暴力的发生率。     

育龄期女性骨代谢与碘摄入过量及甲状腺功能亢进之间的关系研究

目的 观察伴有碘摄入过量或伴有甲状腺功能亢进育龄期女性骨密度及骨代谢指标的变化,探讨碘摄入量及甲状腺功能对育龄期女性骨密度及骨代谢指标的影响.方法 从2500例体检育龄期女性汇总筛选出30例健康育龄期女性,30例伴有甲状腺功能亢进育龄期女性,和30例伴有碘摄入过量育龄期女性,该三种不同状态育龄期女性分别归为对照组、甲亢组和碘摄入过量组.采用双能X线检测仪检测了各组育龄期女性骨密度(BMD)及血清骨代谢指标[骨碱性磷酸酶(BAKP)、骨钙素(OSC)、I型胶原交联羧基末端肽(ICTP)、甲状旁腺素(PTH)和25-(OH) D]的变化.结果 与对照组相比,甲亢组及碘摄入过量组腰椎(L2-4)和右侧桡骨中远1/3处的BMD水平均显著降低(P<0.05);与对照组相比,甲亢组ICTP、BAKP与OSC均显著增加(P< 0.05),碘摄入过量组的ICTP、BAKP、OSC水平则均显著降低(P<0.05),但两组的25-(OH) D和PTH水平无明显改变(P>0.05).结论 伴有碘摄入过量及甲状腺功能亢进的育龄期女性无继发性甲状旁腺功能亢进,无维生素D代谢异常,但有骨代谢失衡(即骨吸收与骨形成失衡)及骨密度降低异常.临床上育龄期女性若出现甲亢或长期碘摄入过量时,应提早治疗或调整以防止骨密度降低即骨质疏松的发生.     

Plasma and pituitary concentrations of LH,FSH, and Prolactin in aging C57BL/6 mice at various times of the estrous cycle

—Plasma and pituitary concentrations of LH, FSH, and prolactin (Prl) were measured by RIA in 2–4, 7–8, 12–13 and 16–20 month-old female C57BL/6 mice during various stages of the estrous cycle. In general, gonadotropin concentrations tended to rise with increasing age and Prl concentrations tended to decline. Pronounced differences existed, however, between the four age groups around the time of the LH surge. LH secretion declined progressively with increasing age at 21.00 hr of proestrus. Aged mice, 16–20 months old, had significantly lower plasma concentrations of LH than did other age groups. It is not known whether age-related changes in the ovary, pituitary, or hypothalamus are largely responsible for differences in the secretion of LH, FSH and Prl in aging C57BL/6 mice.