已酸孕酮治疗子宫内膜癌前期病变的生殖激素水平变化

孕激素类药物治疗子宫内膜癌已有３０多年历史，具有一定疗效，但孕激素类药物的作用环节尚不明确。本研究用已酸孕酮治疗１４例子宫内膜癌前期病变患者，观察用药前后生殖激素水平的变化。结果表明，促黄体生成激素（ＬＨ），促卵泡激素（ＦＳＨ）与促黄体生成激素比值（ＬＨ／ＦＳＨ），均比用药前明显下降（Ｐ＜０．０５，Ｐ＜０．０１）。提示：孕激素类药物的作用是多环节的，其中作用于垂体部位，选择性的影响ＬＨ分泌和ＬＨ／     

促黄体激素释放激素激动剂的临床应用及对骨代谢的影响

应用促黄体激素释放激素激动剂（ＬＨＲＨ－Ａ）２００μｇ，每日肌内注射，连续３个月为１疗程，治疗轻、中型子宫内膜异位症、子宫肌瘤、子宫腺肌症共２０例。结果：用药结束时，促卵泡成熟激素（ＦＳＨ）、黄体生成素（ＬＨ）、雌二醇（Ｅ＿２）均受抑制，分别为４．８±２．９ＩＵ／Ｌ（Ｐ＞０．０５）、４．０±３．５ＩＵ／（Ｐ＜０．０５）、１６０．３±１１０．７ｐｍｏｌ／Ｌ（Ｐ＜０．００１）。临床上体征改善，痛经消失，副反应轻，易为病人接受。２０例用药前后骨钙素（ｏｓｔｅｏｃａｌｃｉｎ）与尿钙、磷测定比较，差异均无显著性（Ｐ＞０．０５）。双能Ｘ线吸收法（ＤＥＸＡ）测量腰椎２～４骨密度，用药３个月下降２％，停药３个月下降１％，尚属正常范围（Ｐ＞０．０５）；单光子吸收法（ＳＰＡ）测量桡、尺骨骨密度也未见影响（Ｐ＞０．０５）。     

子宫肌瘤组织雌、孕激素受体及细胞增殖相关抗原与激素及细胞核体关系的探讨

应用ＡＢＣ法和计算机图象分析系统（ＩＡＳ），定量分析３９例子宫肌瘤患者子宫组织雌激素受体（ＥＲ）、孕激素受体（ＰＲ）、细胞增殖相关抗原（Ｋ１ｉ－６７）的含量；对其中２２例应用放射免疫法测定血浆雌二醇（Ｅ＿２）、孕酮（Ｐ）、促黄体素（ＬＨ）、促卵泡素（ＦＳＨ）含量；以及对其中８例应用立体学方法进行细胞核体定量分析。结果：子宫肌瘤组的ＥＲ、ＰＲ、Ｋｉ－６７显著高于同一子宫正常肌层的含量（Ｐ＜０．０１）；子宫肌瘤的细胞核体数密度和体密度也显著高于同一子宫正常肌层的对应值（Ｐ＜０．０５，Ｐ＜０．０１）；子宫肌瘤的ＥＲ、ＰＲ与血浆的Ｅ＿２、Ｐ含量无明显相关性，而与ＬＨ、ＦＳＨ含量呈负相关（Ｐ＜０．０５）；Ｋｉ－６７与Ｐ呈正相关（Ｐ＜０．０５）；子宫肌瘤的ＥＲ与其细胞核体数密度呈正相关（Ｐ＜０．０５）。提示：子宫肌瘤的发生、发展与雌、孕激素、ＬＨ、ＦＳＨ及其受体含量有关，孕激素在肿瘤发生、发展中可能起协同作用。     

国产雌二醇控释贴片治疗卵巢功能低落176例临床观察

应用双盲法观察国产雌二醇控释贴片治疗卵巢功能低落１０４例（用药组），采用空白贴片治疗卵巢功能低落７２例（对照组），并结合促黄体生成激素（ＬＨ）、促卵泡激素（ＦＳＨ）、雌二醇（Ｅ＿２）测定，阴道壁脱落细胞成熟指数（ＭＩ）和子宫内膜组织学检查综合评价药效。结果表明：用药组贴片对卵巢功能低落所致的潮热、出汗、阴道干涩、头晕、情绪波动及失眠等６项主要临床表现，有显著疗效，有效率分别为９７．９％、９７．５％、９３．７％、７７．０％、７６．２％及７５．０％，且随用药时间延长疗效递增，与对照组比较，差异有显著意义。对ＬＨ、ＦＳＨ释放的抑制作用，在用药的第１０天即已出现。在整个用药期间，ＭＩ升高，血清Ｅ＿２水平轻度升高，浓度平稳。部分患者行子宫内膜组织学检查，未见明显的由于雌激素作用引起的内膜增殖反应。     

重复性早期自然流产病人非孕期血清激素水平和子宫内膜组织E…

用放免法测定了４０例拟诊为由内分泌病因所致的重要性早期自然流产病人卵泡期和黄体期的血清雌二醇（Ｅ２）、孕酮（Ｐ）、卵泡刺激素（ＦＳＨ）、促黄体生成素（ＬＨ）和血清催乳素（ＰＲＬ）水平，同时用生化法测定了相应增生期和分泌期子宫内膜组织中胞浆及胞核的雌、孕激素受体含量。通过和对照组比较，发现重复性早期自然流产病人黄体期和卵泡期的Ｅ２水平均显著低于对照组（Ｐ＜０．００５主Ｐ＜０．０５），其余各项激素水平     

重复性早期自然流产病人非孕期血清激素水平和子宫内膜组织ER、PR含量变化的研究

用放免法测定了４０例拟诊为由内分泌病因所致的重复性早期自然流产病人卵泡期和黄体期的血清雌二醇（Ｅ２）、孕酮（Ｐ）、卵泡刺激素（ＦＳＨ）、促黄体生成素（ＬＨ）和血清催乳素（ＰＲＬ）水平，同时用生化法测定了相应增生期和分泌期子宫内膜组织中胞浆及胞核的雌、孕激素受体含量。通过和对照组比较，发现重复性早期自然流产病人黄体期和卵泡期的Ｅ２水平均显著低于对照组（Ｐ＜０．００５和Ｐ＜０．０５），其余各项激素水平与对照组无差异（Ｐ＞０．０５）；其子宫内膜增生期的胞浆雌激素受体（ＥＲｃ）含量显著低于对照组（Ｐ＜０．００５），分泌期子宫内膜的胞浆孕激素受体（ＰＲｃ）含量亦明显低于对照组（Ｐ＜０．０５）；各期子宫内膜组织的胞核雌、孕激素受体含量在两组间无差异。表明卵巢雌激素分泌不足和子宫内膜组织的受体含量减低是导致该组病人反复自然流产的原因。     

人宫颈粘液葡萄糖、果糖变化规律的研究

本文对月经周期规律的１５例育龄妇女２０个月经周期宫颈粘液及血清葡萄糖、果糖水平进行测定，同时对血清促黄体激素（ＬＨ）、促卵泡激素（ＦＳＨ）、雌二醇（Ｅ２）和孕酮（Ｐ）放免测定；阴道Ｂ超、宫颈粘液Ｉｎｓｌｅｒ评分；尿ＬＨ酶联免疫测定和基础体温（ＢＢＴ）测定，综合评价预测和确定排卵日。２０个周期均为有排卵周期。结果：宫颈粘液葡萄糖、果糖水平均表现为卵泡期稍高，排卵前最低，排卵后逐渐升高，黄体中期达高峰；卵泡期果糖水平与Ｅ２呈负相关（ｒ＝－０．７３，Ｐ＜０．０１）；黄体期葡萄糖、果糖水平均与Ｐ呈正相关（ｒ＝０．９９，Ｐ＜０．０１；ｒ＝０．９８，Ｐ＜０．０１）；血葡萄糖、果糖水平无周期性变化且与宫颈粘液葡萄糖、果糖水平无明显相关性（ｒ＝０．２３，Ｐ＞０．０５）。结论：宫颈粘液葡萄糖、果糖水平变化具有明显规律性，可能与雌孕激素调节有关。     

促性腺激素对人卵巢上皮性癌细胞的增殖作用

目的：了解卵泡刺激素（ＦＳＨ）和黄体生成素（ＬＨ）对人卵巢上皮性癌ＡＯ细胞的作用。方法：用增殖细胞核抗原免疫组化方法和细胞核分裂相计数，检测与ＦＳＨ、ＬＨ（最终浓度分别为２Ｕ／Ｌ、２．５Ｕ／Ｌ，各３份样本）共同培育４８小时后的人卵巢上皮性癌ＡＯ细胞。结果：ＦＳＨ可促进癌细胞增殖，增殖细胞核抗原的表达增加１０％，与对照组比较，差异有显著意义（Ｐ＜０．０５）。光镜下可见，与ＦＳＨ与ＬＨ共同培育后癌细胞分裂相增加（分别增加３５％及１６％）。结论：ＦＳＨ、ＬＨ可促进卵巢上皮性癌ＡＯ细胞的增殖，其中以ＦＳＨ作用较强。在卵巢上皮性癌发展过程中，促性腺激素具有一定的促进作用。     

多囊卵巢综合征患者血清生长激素和泌乳素对左旋多巴反应的研究

目的：探讨多囊卵巢综合征（ＰＣＯＳ）患者生长激素（ＧＨ）和泌乳素（ＰＲＬ）异常分泌的机理。方法：对黄体生成素（ＬＨ）／卵泡刺激素（ＦＳＨ）≥３的１５例患者（Ｉ型组）、ＬＨ／ＦＳＨ＜３的１５例患者（Ⅱ型组）以及２０例月经周期正常妇女（对照组），行左旋多巴（Ｌ－ＤＡ，５００ｍｇ）兴奋下丘脑－垂体轴功能试验，观察３组ＧＨ和ＰＲＬ的浓度变化。结果：在基础状态下，Ⅰ、Ⅱ型组的ＧＨ较低（Ｐ＜０．０１）、ＰＲＬ较高（Ｉ型组，Ｐ＜０．０５）；Ｌ－ＤＡ兴奋试验后，Ⅰ、Ⅱ型组ＧＨ的升高程度和ＰＲＬ的下降程度均低于对照组。结论：ＰＣＯＳ的ＧＨ和ＰＲＬ异常分泌可能与其中枢ＤＡ活性不足有关。     

黄体功能不全与生殖激素的关系

本文对２２例有排卵不孕妇女于Ｂ超监测排卵的同时，在卵泡中期、围排卵期和黄体中期测血清ＬＨ、ＦＳＨ、ＰＲＬ、Ｅ２、Ｐ、Ｔ；排卵后第１０￣１４天取子宫内膜行病理学检查。按子宫内膜发育落后于月经周期〉２天判断为黄体功能不全（ＬＰＤ）。比较ＬＰＤ组（ｎ＝１２）和正常组（ｎ＝１０）生殖激素值与卵泡直径的差异。结果：ＦＳＨ和卵泡期ＬＨ、Ｅ２在两组间无差异，黄体期ＬＨ、Ｅ２、Ｐ水平，ＬＰＤ组低于正常组（Ｐ〈０．     

Effect of follicle-stimulating hormone upon estrogen and progesterone secretion by cultures of monkey granulosa cells recovered during the periovulatory period

For determination of how exposure of the monkey follicle to the preovulatory luteinizing hormone (LH)/follicle-stimulating hormone (FSH) surge alters its responsiveness to FSH in terms of estrogen and progesterone secretory ability, monkey thecal tissue and granulosa cells were harvested prior to and during the midcycle LH/FSH surge and cultured for 8 days with testosterone and with and without 100 ng human FSH. The addition of FSH enhanced estrogen secretion in culture (6.8 and 7 times on the average after 6 and 8 days, respectively; P less than 0.05) by granulosa cells if they were harvested prior to, but not during, the midcycle LH/FSH surge. In contrast, the FSH could stimulate granulosa cell progesterone secretion if the cells were harvested both prior to (60- to 100-fold stimulation) and during the midcycle LH/FSH surge (10- to 60-fold stimulation; P less than 0.05). It can be concluded that exposure of the preovulatory monkey follicle to the midcycle LH/FSH surge alters its responsiveness to FSH in terms of estrogen secretion.     

Ability of luteinizing hormone (LH) to acutely increase serum progesterone levels during the secretory phase of the rhesus menstrual cycle

The acute response (increase in serum progesterone) of rhesus monkeys to a single intravenous injection of luteinizing hormone (LH), follicle-stimulating hormone (FSH), or prolactin was examined. Blood samples were obtained at 0, 20, 40, 60, and 120 minutes posttreatment with gonadotropins on the morning of Day 6 or 21 of the cycle. Neither FSH nor LH induced an increase in progesterone when administered on Day 6. LH increased serum progesterone at all dose levels (50, 250, and 500 mcg) during the luteal phase of the cycle. Values for LH-treated animals were significantly greater than saline controls (P .05), were positively correlated with dose (.632), and the regression was significant (p .01). The mean effect of 1000 mcg of FSH suggests the ability of exogenous FSH to evoke a slight increase in progesterone secretion. Removal of the LH contaminant in FSH by incubation with LH antiserum did not influence the ability of FSH to increase progesterone levels, however, administration of LH antiserum just prior to giving FSH blocked the previously noted progesterone response to FSH. 60 IU of prolactin was without influence in both phases of the cycle. It is concluded that FSH induces changes in progesterone levels by either affecting the receptor site for LH or causing endogenous release of LH.     

Timed analysis of the nuclear maturation of oocytes in early preantral mouse follicle culture supplemented with recombinant gonadotropin

Objective: To analyze the effects of combined FSH and variable doses of LH on the nuclear maturity and capacity to resume meiosis in oocytes from preantral follicles from prepubertal mice.

Design: Prospective, randomized, and controlled in vitro laboratory experiment.

Setting: Academic research environment.

Intervention(s): Meiosis was studied after somatic cell removal or after stimulation with hCG plus epidermal growth factor in three culture conditions: maturation medium with FSH alone and with two different doses of LH.

Main Outcome Measure(s): The nuclear maturation of the oocytes and the E₂, progesterone, and -specific inhibin content of the conditioned medium.

Result(s): Somatic cell removal and hormonal stimulation were equally effective in inducing germinal vesicle breakdown, but the hormonal stimulus was essential for the completion of meiosis, which was maximal (70%) on day 13 of culture. Continuous addition of LH to FSH during the oocytes’ growth made them more prone to spontaneous resumption of meiosis I but resulted in a higher proportion of oocytes reaching the completion of meiosis. Estradiol and progesterone measurements demonstrated that the presence of LH influences luteinization.

Conclusion(s): In contrast to oocytes grown in vivo, cumulus cell removal by itself is an insufficient stimulus for oocytes cultured in vitro to complete meiosis. Timed stimulation with hCG and epidermal growth factor increases nuclear maturation rates. A maximum number of metaphase II oocytes are obtained after a 13-day in vitro growth period when LH is added to the maturation medium.     

Evaluation of the preovulatory rise of follicle stimulating hormone and progesterone in normally ovulating women of reproductive age

Sixteen normally ovulating women of reproductive age were evaluated to determine the extent of the preovulatory FSH and progesterone rise in association with the LH surge. Highly significant differences were demonstrated between the baseline and peak preovulatory levels of both FSH and progesterone (P less than .0005). These significant peak ovulatory differences of FSH and progesterone were associated with a 2.5-fold rise (mean difference of 9.06 mIU/mL) of FSH and a 3.0-fold rise (mean difference of 1.94 ng/mL) of progesterone. These small, yet very significant, preovulatory increments of FSH and progesterone are important in the ovulatory process and the formation of an adequate corpus luteum.     

Abnormal patterns of pulsatile luteinizing hormone in women with luteal phase deficiency

Luteal phase deficiency is usually a problem of inadequate progesterone production associated with inadequate ovarian follicular development. The hypothesis that luteal phase deficiency results from an abnormal secretion pattern of luteinizing hormone (LH) was tested in these women. To this end, the early follicular LH secretion pattern in four women with luteal phase deficiency was characterized and compared with patterns in normal women. Blood samples were obtained through indwelling catheters every ten minutes for eight hours (10 AM to 6 PM), and plasma levels of LH and FSH were measured. Luteinizing hormone and FSH secretion profiles were analyzed for pulse frequency, amplitude, and mean plasma level. A significantly greater LH pulse frequency in women with luteal phase deficiency was observed when compared with the frequency in normal controls (luteal phase deficiency, 10.5 pulses/eight hours; normal, 5.2 pulses/eight hours; P less than or equal to .05). The mean FSH concentration was less in the women with luteal phase deficiency, but the level was not significant. These data suggest that the abnormal LH secretion pattern observed in women with luteal phase deficiency is responsible for their inadequate luteal phase progesterone secretion and their infertility.     

Ovarian follicular maturation in women. II. Reversal of estrogen inhibited ovarian folliculogenesis by human gonadotropin

The current study was undertaken to investigate the role of follicle-stimulating hormone (FSH) in reversing estrogen-induced follicular atresia. Normal menstruating women received ethinyl estradiol (EE2) 50 micrograms/day orally from days 2 to 7 after the onset of menses. Concomitant intramuscular injections of 1.0 ml of saline were administered to group 1, 75 IU of FSH and luteinizing hormone (LH) to group 2, and 150 IU units of FSH and LH to group 3. Daily blood samples were obtained throughout the investigative cycle for FSH, LH, 17 beta-E2, and progesterone. The women in group 1 had evidence of follicular atresia and a significant reduction in serum FSH and LH when compared to group 3 (P less than 0.002 and less than 0.001 respectively). Ovarian follicular development was maintained in groups 2 and 3, based on ultrasound evidence and the interval from menses to midcycle LH surge. These data indicate that the exogenous administration of FSH and LH results in maintenance of ovarian follicular development in women treated with exogenous estrogen.     

The influence of progesterone and clomiphene on the length of the menstrual cycle and on the LH and FSH levels in plasma.

100 mg progesterone, administered on the 5th cycle day, prolonged the length of the cycle, whereas clomiphene, given from day 1 to day 5, had no such effect. Clomiphene given together with progesterone did not inhibit the cycle-lengthening effect of progesterone.From the influence of progesterone alone and the combined influence of progesterone and clomiphene on the LH and FSH levels in the plasma it was deduced that the cycle-lengthening effect of progesterone was due to a short-lasting depletion of pituitary LH. The relation between the lengthening of the menstrual cycle and the LH and FSH levels in the plasma is discussed. Progesterone is thought to discharge stored LH from the pituitary.     

Lipid and hormonal profile of Panamanian women during the menstrual cycle.

Forty-one women of reproductive age were included in the study, to establish the variation of serum lipids during the menstrual cycle and simultaneously, to determine the physiological fluctuation of FSH, LH, prolactin (PRL), progesterone (P4) and estradiol (E2) concentration in serum, during the menstrual cycle. A significant decrease of total serum cholesterol (165.29 +/- 3.6 mg/dl) and triglycerides (108.99 +/- 9.65) occurred during the luteal phase, as compared with the follicular phase (176.16 +/- 3.51, 108.99 +/- 9.65). Changes were not observed with HDL-cholesterol during the cycle. On the other hand, FSH showed an initial rise (mean 5 IU/l) followed by a surge (10 IU/l) and a progressive fall toward the midcycle. In contrast LH secretion showed a steady increase with a maximal concentration at surge (32.1 IU/l). PRL mean value was observed, with a discrete increase after day 13 of the menstrual cycle, that was more noticeable at the end of the cycle. Forty-eight hours after the FSH and LH midcycle surge, elevation of progesterone was observed, with maximal concentration occurring on day 24 (23 nmol/l) and later on progesterone levels fell rapidly. Thirty-six to 24 h before the surge of LH and FSH at midcycle was observed the peak serum concentration of estradiol (1300 pmol/l) followed by a progressive fall. Changes in the concentration of serum lipids during the menstrual cycle are presumably due to a direct or indirect effect of physiological fluctuation of sex hormones.     

Interrelationships between plasma hormone levels and the content of total protein, gonadotropins and steroid hormones in antral fluids of women undergoing in vitro fertilization

Follicle development was induced in 41 women with follicle-stimulating hormone (FSH) and human menopausal gonadotropin. Blood samples were drawn and follicular fluids (FF) were aspirated when two or more follicles attained diameters of 15 to 17 mm. Levels of estradiol (E2), progesterone (P), FSH, and luteinizing hormone (LH) were determined in samples by radioimmunoassay, and relationships between the measured parameters in antral fluids and in serum were examined by least-squares linear regression analysis. Levels of LH in serum correlated with LH and FSH levels in FF (P less than 0.005). Concentrations of FSH in serum were positively related to levels of LH, FSH, E2, and total protein in FF (P less than 0.005). E2 levels in serum were predictive of E2 levels in FF only, and levels of P in serum were directly correlated with P levels in FF (P less than 0.05). With respect to the peculiarly broad range of predictions that could be drawn from the FSH content of serum, peripheral FSH provided a better predictive index of the chemical composition of antral fluid than did the level of any other single hormone measured in serum.     

153例月经过少患者的性激素检测结果分析

目的:通过了解月经过少患者性激素情况,为临床诊疗提供重要参考。方法:对153例月经过少患者的性激素即雌二醇(E_2)、睾酮(T)、催乳素(PRL)、促黄体生成激素(LH)、促卵泡激素(FSH)、孕酮(P)等结果进行回顾性分析。结果:实验组与对照组比较,PRL结果的差异有统计学意义(P<0.05),LH、E_2、P、T、FSH结果的差异无统计学意义(P>0.05)。但有24例(15.7%)的患者E_2检测结果低于正常对照的下限;有28例(18.3%)的患者T检测结果比正常对照上限高。结论:性激素检测结果对月经过少的的诊治有重要意义。