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1.
目的探讨性激素结合球蛋白(SHBG)检测在评价治疗多囊卵巢综合征(PCOS)不育患者中的意义。方法将533例PCOS不育患者按体重指数(BMI)分为非肥胖组(424例)和肥胖组(109例)并再按是否存在胰岛素抵抗(IR)分为四组。A组:非肥胖无IR组(162例)、B组:非肥胖IR组(262例)、C组:肥胖无IR组(42例)、D组:肥胖IR组(67例)。测定黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_2)、总睾酮(T)、泌乳素(PRL)、SHBG、血糖(FBG)和胰岛素(FINS)水平,计算游离雄激素指数(FAI)及稳态模型指数(HOMA-IR)。A组、C组予达英-35;B组、D组予达英-35+盐酸二甲双胍,均治疗3月后复查各指标。停药后给予枸橼酸氯米芬(克罗米芬,CC)+人绝经期促性腺激素(HMG)促排卵治疗。比较各组排卵及妊娠情况。结果四组治疗后FAI均较治疗前降低,SHBG较治疗前升高差异有显著性;四组治疗后LH、LH/FSH比值、T较治疗前降低差异有显著性;但A组HOMA-IR、FINS较治疗前升高差异有显著性,B、D组HOMA-IR、FINS较治疗前降低差异有显著性。促排卵结果显示治疗后排卵率非肥胖组高于肥胖组(85.60%vs 68.69%,P0.01),两组治疗后有排卵患者SHBG较无排卵患者升高,FAI较无排卵患者降低;非肥胖组LH、LH/FSH比值、FINS降低(P0.05),而肥胖组FINS、HOMA-IR则降低(P0.05)。妊娠结局比较:非肥胖组和肥胖组妊娠分娩患者治疗后T、FAI、FINS、HOMA-IR较自然流产患者降低,SHBG升高(P0.05);此外肥胖组妊娠分娩患者治疗后BMI较自然流产患者降低。结论无论肥胖还是非肥胖的PCOS患者,无论是否存在胰岛素抵抗,SHBG及FAI均可作为评价治疗是否有效的指标之一,可提示促排卵治疗及妊娠结局。因此在PCOS患者治疗中检测SHBG及FAI能指导临床用药,降低流产率,对优生优育有重要指导意义。  相似文献   

2.
目的探讨二甲双胍治疗青春期多囊卵巢综合征患者的临床疗效。方法回顾性分析我院2011~2013年妇科收治的80例青春期多囊卵巢综合征患者的资料,随机分为观察组及对照组,各40例,两组均采用达英-35治疗,观察组患者加用二甲双胍片,连续治疗3个月,比较两组患者治疗前后血浆性激素、空腹血糖及空腹胰岛素变化情况。结果两组患者血浆性激素FSH、LH、LH/FSH、T指标均下降,观察组患者下降更为明显,比较差异有统计学意义(P〈0.05);两组患者FBS、FIN及HOMA—IR均有改善,观察组患者改善更明显,比较差异有统计学意义(P〈0.05)。结论二甲双胍联合达英-35治疗青春期多囊卵巢综合征,能改善患者临床症状、卵巢功能及胰岛素抵抗,有效降低雄激素水平,疗效满意。  相似文献   

3.
目的 通过口服避孕药对卵巢早衰患者血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平及围绝经期症状的观察分析,探讨卵巢早衰的有效治疗方法.方法 将114例卵巢早衰患者随机分为两组,每组57人,第一组单服妈富隆片(妈富隆组),第二组予补佳乐片+安宫黄体酮片(HRT组),于治疗后3、6、9月分别观察两组病人的潮热、盗汗、失眠、烦躁、注意力、乳房萎缩、生殖器萎缩等围绝经期症状以及血清FSH、LH、E2 的水平变化.并对治疗显效的患者进行促排卵+中药治疗,指导受孕.结果 治疗后两组患者的围绝经期症状都显著改善,但组间无显著性差异;妈富隆组血清FSH、LH水平下降速度和幅度明显优于HRT组;E2水平上升、卵巢排卵恢复在两组无显著性差异.结论 口服妈富隆片对降低高水平的FSH、LH疗效显著,是治疗卵巢早衰的一种有效方法.  相似文献   

4.
目的探讨复方环丙孕酮联合二甲双胍治疗肥胖型多囊卵巢综合征的疗效。方法选择2007年1月~2010年10月在笔者所在医院门诊就诊的57例肥胖型多囊卵巢综合征患者,随机分成两组。A组27例给予CPA联合二甲双胍治疗;B组30例给予CPA治疗,疗程为6个月。比较两组患者用药前后的体重指数(BIM)、性激素和空腹胰岛素水平(FINS)变化。结果用药6个月后,A组BIM、FINS较治疗前明显下降(P〈0.05),B组BIM、FINS较治疗前无明显变化(P〉0.05),两组治疗后LH、LH/FSH、血清雄激素均明显下降(P〈0.05),但两组间差异无统计学意义(P〉0.05)。结论 CPA联合二甲双胍治疗肥胖型多囊卵巢综合征的疗效优于单一CPA。  相似文献   

5.
目的观察炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征不孕症的效果。方法随机将60例多囊卵巢综合征不孕患者分为2组,每组30例。对照组应用炔雌醇环丙孕酮片治疗,观察组采用炔雌醇环丙孕酮联合二甲双胍治疗,比较2组治疗效果。结果治疗前2组患者的BMI、FSH、T、FINS、LH差异无统计学意义(P0.05)。治疗后,2组各项指标均较治疗前显著下降,差异有统计学意义(P0.05)。其中观察组T、FINS较对照组明显改善,差异有统计学意义(P0.05)。2组BMI、LH、FSH的差异无统计学意义(P0.05)。随访6个月,观察组患者的排卵率、妊娠率均高于对照组;先兆流产率低于对照组,2组差异有统计学意义(P0.05)。结论炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征不孕症,可有效降低体内雄激素水平,提高患者的排卵率和妊娠率,效果满意。  相似文献   

6.
目的探讨B超引导下经阴道卵泡穿刺术联合二甲双胍治疗多囊卵巢综合征(PCOS)临床效果。方法46例PCOS不育患者分为两组,A组(n=21)行B超引导卵泡穿刺术,B组(n=25)卵泡穿刺术联合二甲双胍治疗,观察穿刺术前后血内分泌水平和卵巢窦卵泡数变化及比较术后3个月两组内分泌水平和妊娠率。结果穿刺术前后比较,两组两侧卵巢的窦卵泡数均显著减少(P〈0.01);A组血黄体生成素(LH)和睾酮(T)水平有所下降,B组LH和T水平则显著降低(P〈0.05);穿刺术后3个月,两组空腹胰岛素(FINS)、LH和T水平比较有显著性差异(P〈0.05),妊娠率两组比较无显著差异。结论B超引导下经阴道卵泡穿刺术联合二甲双胍治疗PCOS,能更有效改善PCOS患者内分泌异常。  相似文献   

7.
目的探讨前列腺癌患者药物去势和手术去势后性激素、甲状腺激素和糖脂水平的变化。方法对39例行手术去势、21例药物去势(戈舍瑞林3.6 mg每4周皮下注射1次)的前列腺癌患者治疗前及治疗后3个月的血清性激素、甲状腺激素及血糖、血脂水平变化进行回顾性观察比较。结果治疗后两组PSA均显著下降(P〈0.01),但组间比较无差异(P〉0.05)。手术组手术后3个月,睾酮(T)和雌二醇(E2)明显下降,FSH及LH的水平明显升高(P〈0.01);药物治疗组治疗后3个月T、E2、FSH和LH均明显下降(P〈0.01)。手术组治疗后3个月的FSH和LH水平明显高于药物去势组(P〈0.01)。而PRL治疗前后无明显变化。治疗前后甲状腺激素和空腹血糖水平均无显著变化。血脂方面,甘油三脂、胆固醇、低密度脂蛋白两组均较治疗前升高(P〈0.05),但无组间差异(P〉0.05);高密度脂蛋白治疗前后及组间比较均无统计学差异。结论药物去势和手术去势3个月均可显著降低睾酮,并影响到脂代谢。  相似文献   

8.
目的:了解南京城区中老年男性生殖健康的基本情况。方法:随机对南京玄武区884例55~89岁的中老年男性进行常规体检,实验室检测血常规、肝肾功能、血糖、血脂及总前列腺特异性抗原(T-PSA)等指标,用放射免疫法测定血清总睾酮(TT)、游离睾酮(fT)、性激素结合球蛋白(SHBG)及黄体生成素(LH)等生殖激素指标。并收集119例20~39岁青年男性血清生殖激素指标作为对照。结果:中老年男性的生殖激素中除TT及E2之外,其他6项生殖激素及相关参数(LH、FSH、fT、SHBG、TSI、fTI)的中位数(50%位数)随年龄增加均呈现梯度性变化,LH、FSH及SHBG水平逐渐增高,而fT、TSI、fTI则逐渐降低。采用Mann-Whitney U法比较5个年龄组(20~39岁,55~59岁,60~69岁,70~79岁,≥80岁)两两之间的生殖激素或相关参数水平差异后发现:①TT水平,除了对照组与≥80岁年龄组、60~69岁组与≥80岁组间有统计学差异外(P0.05),其他各组间均无统计学差异(P均0.05);②E2水平,各组间均无统计学差异;③LH、FSH水平,除了55~59岁与60~69岁组间及FSH水平70~79岁与≥80岁组间无统计学差异外,其他各组间均有统计学差异;④fT、TSI水平,除了55~59岁组与60~69岁组间无统计学差异,其他各组间均有统计学差异;⑤SHBG及fTI水平,所有组间均有显著性差异。而对生殖激素及相关指标与年龄、LH等因素进行相关性分析后发现:fT、TSI、fTI与年龄、LH显著负相关(P0.01,|r|0.4),而与胆固醇、血糖及血红蛋白呈相对较弱的正相关(P0.01,r0.4);SHBG及LH与年龄呈显著正相关(P0.01,r0.4),SHBG与血糖及血红蛋白呈相对较弱的负相关(P0.01,|r|0.4),LH与血红蛋白呈相对较弱的负相关(P0.01,|r|0.4);TT与年龄呈相对较弱的负相关(P0.01,|r|0.4),而与血红蛋白呈相对较弱的正相关(P0.01,r0.4)。结论:随着年龄增长,中老年男性血清TT(fT更为明显)水平下降,并可能引起脂质代谢异常、血红蛋白降低及血糖升高。  相似文献   

9.
目的:探讨肥胖男性青少年性发育特点并对性激素水平进行分析。方法:选择自2010年1月至2012年6月期间到我院泌尿外科因小睾丸、小阴茎就诊的肥胖男性青少年156例为观察组,对照组选择社区健康青少年男性50例,测算两组对象的体重指数(BMI)、阴茎自然长度、睾丸容积并询问有无遗精及首次遗精年龄,采用放射免疫分析法测定血清黄体生成素(LH)、卵泡刺激激素(FSH)、催乳素(PRL)、总睾酮(TT)、游离睾酮(FT)、孕激素(P)和雌二醇(E2)水平,并计算TT/E2、睾酮分泌指数(TSI)。结果:①观察组BMI[(27.1±2.2)kg/m2]显著高于对照组[(20.4±1.6)kg/m2](P<0.05),阴茎自然长度[(5.6±1.7)cm]及睾丸平均容积[(7.6±2.3)cm3]显著小于对照组(P<0.05);两组青少年首次发生遗精年龄未现显著性差异(P>0.05),但观察组遗精发生率较对照组有极显著性下降(χ2=17.335,P<0.05)。②观察组血清LH、FSH、PRL、TT、FT、E2、P分别为(7.82±2.14)mIU/ml、(7.71±1.83)mIU/ml、(8.91±3.52)ng/ml、(0.73±0.20)ng/ml、(5.09±2.60)pg/ml、(48.57±8.34)pg/ml、(1.25±0.58)ng/ml,对照组分别为(5.39±1.76)mIU/ml、(6.82±2.01)mIU/ml、(8.26±2.97)ng/ml、(1.47±0.41)ng/ml、(11.28±4.72)pg/ml、(8.61±4.08)pg/ml、(0.64±0.19)ng/ml,其中观察组LH、E2、P显著高于对照组(P<0.05,P<0.01,P<0.05),TT、FT显著低于对照组(P均<0.01)。观察组TT/E2值(0.015±0.004)较对照组(0.173±0.037)显著降低(P<0.01);观察组TSI为(0.098±0.026),显著低于对照组(0.272±0.084,P<0.01)。③相关分析表明,BMI与PRL、E2呈显著正相关,与TT、FT、TT/E2及TSI呈显著负相关(P<0.05);阴茎自然长度与TT、FT、TT/E2及TSI呈显著正相关,与E2呈显著负相关(P<0.05);睾丸平均容积与LH、PRL、E2呈负相关,与TT、FT、TT/E2、TSI呈正相关(P<0.05)。结论:肥胖男性青少年存在性发育不良及性激素水平改变,肥胖及脂肪积聚导致E2增高、TT及FT下降、TT/E2、TSI下降尤为明显并与性发育存在显著相关性,提示男性青少年体内的脂肪含量对其生殖系统发育具有重要影响。  相似文献   

10.
目的 比较2型糖尿病(T2DM)患者血浆C反应蛋白(CRP)水平变化并探讨与代谢综合征(MS)的关系。方法 受试者分为三组:肥胖的T2DM组68例(A组)、非肥胖的T2DM组86例(B组)和正常体重对照组68例(C组)。测定血清CRP水平,同时检测体重指数(BMI)、腰围(W)、腰臀比(WHR)、血压、糖脂代谢参数、空腹胰岛素(FINS),以稳态模式(HOMA)公式评估胰岛索抵抗(HOMA-IR),并对导致血清CRP改变的因素进行相关分析。结果 (1)A和B组血清CRP显著高于C组(P〈0.01),A组的CRP也明显高于B组(P〈0.01)。(2)A组患者血清CRP与SBP、WHR、BMI、TG和HOMA-IR存在显著正相关,与其他变量无显著相关性。结论 T2DM患者血清CRP水平明显高于非糖尿病患者,肥胖的T2DM患者血清的CRP水平升高与MS、胰岛素抵抗(IR)有密切关系。  相似文献   

11.
男性海洛因依赖者性功能研究   总被引:1,自引:0,他引:1  
对56名男性海洛因依赖者进行体检、吸毒史与性生活史调查,其中30名检测了血清T、FT、PRL、FSH、LH及血SHBG等浓度水平。以30名健康男性为对照组。结果表明,吸毒前性功能基本正常,吸毒后83.9%出现性欲低下,性交频率明显低于吸毒前(P<0.01),94.6%存在阴茎勃起障碍,21.4%有射精延迟;血清T、FT、FT/T及LH浓度明显低于对照组;血清PRL浓度则高于对照组。本结果证实了海洛因依赖可导致男性下丘脑-垂体-睾丸轴功能紊乱及男性性功能异常,并阐明了两者之间的内在联系。  相似文献   

12.

Background

Male obesity can be associated with symptomatic alterations in sex hormones resulting in hypogonadism and impaired fertility. Surgical-induced weight loss can improve the sex hormone profile in men. The aim of the present study is to evaluate the levels of sex hormones in obese males before and after 6 months from bariatric surgery. Possible mechanisms and clinical implications are also discussed.

Methods

We evaluated levels of serum total testosterone (TT), sex hormone-binding globulin (SHBG), calculated free testosterone (cFT), follicular-stimulating hormone (FSH), luteinizing hormone (LH), and total estradiol (E2) in 20 male patients at the baseline and 6 months after bariatric surgery.

Results

Median [interquartile range] age at the time of surgery was 40.5 [27.2–46.7] years with a median [interquartile range] BMI of 43.6 [40.9–48.7] kg/m2. The median baseline levels of TT, SHBG, cFT, LH, and FSH were reduced; levels of E2 were elevated. At 6 months from surgery, the median BMI dropped to 34.8 [31.7–40.5]?kg/m2, TT, SHBG, cFT, LH, and FSH increased, while levels of E2 decreased. The improvement in the sex hormone profile was more evident in younger patients, with a statistically significant difference in cFT following surgery and in the raise of TT and cFT between the groups of patients below and above 35 years. At multivariate analysis, the age was the best predictive factor of the postoperative variations of TT.

Conclusions

These preliminary results confirm the general improvement in sex hormone profile in obese men after bariatric surgery and introduce the age as a possible contributing factor to this improvement.  相似文献   

13.
There are few systematic studies on the relationship between blood testosterone concentrations and the symptoms of androgen deficiency in ageing males. To assess the changes in sex hormone levels with age in relation with some lifestyle factors, the serum levels of total testosterone (TT), sex-hormone binding globulin (SHBG), luteinising hormone (LH) and follicle stimulating hormone (FSH) were measured in 33 men, age range 40-89 years. In addition, free testosterone (FT) and the free androgen index (FAI) were calculated. Seventeen healthy men under 40 years were involved as controls. The men over 40 years revealed significantly decreased TT, FT and FAI, and in the subgroup of men over 60 years, FSH and SHBG were significantly increased. Pearson's analysis showed that TT levels were significantly correlated with body mass index (BMI) (r = -0.464, P < 0.01) and body weight (r = -0.413, P < 0.05). SHBG levels were significantly correlated not only with age (r = +0.407, P < 0.05), but also with LH (r = +0.605, P < 0.001) and alcohol consumption (r = +0.382, P < 0.05). In conclusion, the TT, FT and FAI decreased in males over 40 years, but the alterations in hormone levels with age are more pronounced in men over 60 years. The important determinants of sex hormones are age, BMI and some lifestyle factors.  相似文献   

14.
目的比较肥胖多囊卵巢综合征(PCOS)与肥胖非PCOS患者血脂水平及体脂分布差异,探究肥胖PCOS患者脂代谢异常的特点及影响因素。方法回顾性分析2017年12月至2018年6月就诊于盛京医院内分泌科的86例门诊患者,其中56例肥胖PCOS患者为肥胖PCOS组,30例匹配年龄、体重指数(BMI)的肥胖非PCOS患者为肥胖非PCOS组。检测身高、体重、内脏脂肪面积、血脂、性激素、甲状腺功能、hsCRP、空腹血糖及胰岛素水平,比较两组患者的代谢相关指标及激素水平,并做指标间的相关性分析。结果肥胖PCOS组血浆总胆固醇(TC)、低密度脂蛋白(LDL)、载脂蛋白B(ApoB)、LH、FSH、LH/FSH、睾酮(T)、游离雄激素指数(FAI)高于肥胖非PCOS组,血清游离甲状腺素(FT4)低于肥胖非PCOS组,均有统计学差异(P<0.05)。T、FAI、LH、FSH与TC呈正相关,T、LH与LDL呈正相关,T与ApoB呈正相关(P均<0.05)。肥胖PCOS组内脏脂肪面积、BMI与腰围之间两两呈正相关,腰围、BMI均与胰岛素抵抗指数(HOMA-IR)、超敏C反应蛋白(hsCRP)呈正相关,内脏脂肪面积与T呈正相关,甘油三酯(TG)与FAI呈正相关,HDL与hsCRP呈负相关(P均<0.05)。结论肥胖PCOS患者血脂异常程度比普通肥胖患者更严重,血清TC、LDL、ApoB水平显著升高,高雄激素可能是导致血脂差异的重要原因之一。与肥胖相关的慢性炎症状态也在一定程度上引起脂代谢紊乱,可以通过减重有效缓解肥胖PCOS患者的血脂异常。  相似文献   

15.
Premature ejaculation (PE) is the most common male sexual dysfunction. This study aimed to investigate the role of serum testosterone, gonadotropins and prolactin in patients with PE. In a prospective a case‐controlled study, it was conducted on 90 male patients with PE and 90 male healthy participants as controls. Patients were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT). Patients with mean IELT values ≤60 s and PEDT total scores ≥11 were considered to have PE. Serum levels of total testosterone (TT), free testosterone (FT), follicle‐stimulating hormone (FSH), luteinising hormone (LH) and prolactin (PL) were investigated in patients with PE and controls. There was no statistically significant difference between patients with PE and controls regarding the serum levels of TT, FT, FSH, LH and PL (p value ?.05). There was no significant correlation between the sex hormones levels (TT, FT, FSH, LH and PL) and (age, body mass index (BMI), IELTS and total PEDT scores of the patients; p value ?.05). This study concluded that there was no disturbance in serum levels of testosterone, gonadotropins and prolactin in patients with PE and controls. These hormones could not relate to pathogenesis of PE.  相似文献   

16.
BackgroundMost studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones.ObjectiveA systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS.SettingsElectronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies.MethodsThe heterogeneity of the studies was examined by χ2 tests and the degree of heterogeneity was estimated using I2 statistic.ResultsThe results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS.ConclusionBS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims.  相似文献   

17.
BackgroundMale obesity secondary hypogonadism (MOSH) is a common disease among men with obesity and can be associated with metabolic syndrome and a variety of metabolic problems ultimately leading to androgen deficiency. Metabolic and bariatric surgery is a well-established treatment option associated with significant weight loss and reduction in metabolic co-morbidities.ObjectivesTo evaluate the impact of surgery on plasma levels of sexual hormones and their effect on weight loss comparing 2 surgical methods (one-anastomosis gastric bypass [OAGB] and Roux-en-Y gastric bypass [RYGB]) in male patients with obesity.SettingUniversity hospital, Austria.MethodsPatients undergoing OAGB and RYGB between 2012 and 2017 were analyzed retrospectively. Follow-up in this study was up to 24 months. Systemic levels of sexual hormones (luteinizing hormone [LH]), follicle stimulating hormone [FSH], total testosterone [TT], sexual hormone binding globin [SHBG], 17 beta-estradiol [17bE], androstenedione [AS]) were retrieved at each visit. A linear mixed model was used to assess the correlation between changes in testosterone levels and percent excess weight loss (%EWL).ResultsIn 30.8% of all patients, MOSH was present preoperatively. A significant increase of TT was observed postoperatively that led to a complete resolution of hypogonadism within the period observed. Bioavailable testosterone (bTT) and FSH levels significantly increased each month of follow-up after surgery (all P < .01). Levels of 17bE did not change significantly after surgery. The overall change of TT, comparing preoperative and 1-year postoperative TT levels (ΔTT), significantly correlated with %EWL. Changes in TT levels were not affected by the choice of surgical method.ConclusionsSerum plasma testosterone levels rise significantly after metabolic and bariatric surgery in male patients. The change of testosterone levels seems to play a role in continued weight loss after surgery. This is true irrespective of the surgical method used.  相似文献   

18.
目的 观察来曲唑、枸橼酸氯米芬分别联合复方玄驹胶囊及维生素E治疗肥胖性少弱精子症的临床疗效.方法 选取2018年8月至2020年8月在洛阳市妇幼保健院生殖医学研究所就诊的188例肾阳不足型肥胖性少弱精子症患者,随机分为来曲唑联合组(A组)和枸橼酸氯米芬联合组(B组)各94例,疗程为3个月,以精子浓度、精子前向运动百分率...  相似文献   

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