675例女性不孕症患者血清基础性激素水平分析

目的探讨女性不孕症患者血清基础性激素检测的临床意义.方法回顾分析675例女性不孕症患者血清基础性激素水平.结果本文675例女性不孕症患者中除≥40岁组FSH水平显著高于其它年龄组(P＜0.01)外,各年龄组其它指标无显著性差异(P ＞0.05).E2＜10ng/L、10ng/L≤E2＜50ng/L、50ng/L≤E2≤80ng/L、80ng/L＜E2＜100ng/L、E2≥100ng/L者分别为7.4%、58.8%、23.4%、6.1%、4.3%;FSH＜5 IU/L、5 IU/L≤FSH≤10 IU/L、10 IU/L＜FSH≤20 IU/L、20 IU/L＜FSH≤40 IU/L、FSI＞40 IU/L者分别为19.696、73.5%、5.9%、0.3%、0.7%:LH＜5 IU/L、5 IU/L≤LH≤10 IU/L、10 11U/L＜LH≤20 IU/L、20 IU/L＜LH≤40 IU/L、LH＞40 IU/L者分别为53.8%、39.1%、5.0%、1.3%、0.7%;P ＞2.0μg/L者0.6%;PRL＞35μg/L者10.2%;T＞2.8nmol/L者3.0%.而FSH＜5 IU/L且LH＜5 IU/L者13.8%,FSH＞40IU/L且LH＞40 IU/L者0.6%;5 IU/L≤FSH≤20 IU/L且E2＜80ng/L者72.4%;5 IU/L≤FSH≤20 IU/L、5 IU/L≤LH≤20 IU/L且FSH/LH＞3.6者1.8%.结论女性不孕症患者血清基础性激素水平检测具有重要的临床意义,可为不孕症的诊治提供有价值的依据.     

基础FSH/LH比值与高孕激素状态下促排卵结局相关性研究

目的探讨高孕激素状态下促排卵(PPOS)方案中基础卵泡刺激素/黄体生成素(FSH/LH)比值对患者促排卵结局的影响。方法回顾性分析武汉大学人民医院生殖医学中心接受PPOS方案超促排卵治疗,FSH10IU/L患者资料共511例。根据患者基础性激素水平分为FSH/LH2组与FSH/LH≥2组,比较两组患者的一般情况、促排卵治疗情况与胚胎实验室结局。结果两组患者年龄、不孕年限、既往IVF周期数、BMI无明显差异(P0.05)。FSH/LH≥2组患者bFSH升高、bLH下降、bE_2下降(P0.05),扳机日E_2水平与卵泡数减少(P0.05),获卵数减少(P0.001),Gn总量升高(P0.001)。但最终两组患者优胚数、可移植胚胎数无明显差异(P0.05),且FSH/LH升高组患者优胚率有显著提升(P0.01)。结论 PPOS方案能够有效改善FSH/LH比值升高患者胚胎情况,可作为FSH/LH比值升高卵巢储备功能下降患者的有效超促排卵方案。     

缺氧对男性肺心病患者急性发作期下丘脑-垂体-性腺轴功能变化的影响

本文应用放免法检测了50例急性发作期男性肺心病患者及26名正常健康男性之血浆睾酮(T)、雌二醇(E_2)、血清黄体生成激素(LH)、卵泡刺激素(FSH)水平及对黄体生成激素释放激素(LRH)刺激的反应性。结果表明,急性发作期血浆T值明显降低(P<0.01),E_2/T比值显著升高(P<0.01);缓解期二者均恢复至对照水平。急性发作期患者对LRH刺激之反应亦有所减退。血浆E_2、血清LH和FSH水平均无明显变化。患者血浆T值与PaO_2呈明显正相关,E_2/T比值与PaO_2,呈明显负相关,T值、E_2/T比值与PaCO_2均无相关关系。作者提出:缺氧是导致男性肺心病患者急性发作期下丘脑-垂体-性腺轴功能改变的重要影响因素。     

血清FSH、LH、E_2 RIA在女性性早熟诊断中的应用

我们用放射免疫分析法(RIA)对78例患儿,其中真性性早熟22例、假性性早熟56例与25例正常女性儿童血清中卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)进行检测,并探讨其临床意义。 材料和方法 一、对象: (一)对照组:正常发育儿童25例,来自本院住院患儿,均为炎症患者,检查均无第一、第二性征发育,年龄3～9岁。 (二)性早熟组均来自本院门诊或住院患儿,22例真性早熟患儿年龄3.5～9岁。其中18例有双侧乳房发育,15例有阴毛出现并伴有外阴色素沉着等第二性征出现。B超示女孩子宫和卵巢均有不同程度的发育且有不规则阴道流血。56例假性性早熟患儿的龄4—9岁,仅有单纯乳房发育或出现阴毛、外阴色素沉着等第二性征出现,B超示子宫卵巢均未有明显发育。 二、方法: (一)采血:晨起8时采集空腹静脉血3ml,离心取血清置于-20℃保存,一次性检测。 (二)FSH、IH、E_2试剂盒由天津九鼎公司提供,操作按说明书。 (三)仪器:中国科技大学GC-911 γ计数器。 结果 一、由表1可见,假性性早热与对照组相比FSH、LH均无显著性差异(p>0.05),只有E_2明显高于对照。而真性早熟FSH、LH、E_2均明显高于对照组,同时与假性性早熟们相比,也有显著差异     

人腔前卵泡体外培养研究

目的探讨FSH对人腔前卵泡(preantralfollicle)体外生长的影响.方法培养液中加入不同浓度的FSH,观察卵泡存活天数和卵泡发育增大.结果卵泡体外存活天数对照组为2.80±1.69天,Ⅰ、Ⅱ、Ⅲ组(FSH浓度为0.5IU/ml、1IU/ml、2IU/ml)分别为5.36±0.63、5.47±2.50、8.13±4.19天,与对照组相比,分别为P＜0.05、P＜0.01、P＜0.001.卵泡增大比率对照组为20.00%,Ⅰ、Ⅱ、Ⅲ组分别为35.71%、60.00%、81.25%,与对照组相比分别为P＞0.05、P＜0.05、P＜0.01.结论FSH能使卵泡体外存活天数延长,卵泡发育增大,并大致呈正相关关系.     

X染色体长臂缺失伴原发性闭经2例报告

病例报告 例1,女,17,未婚。因一直无月经来潮来我院就诊。母亲孕期正常,足月顺产,其父在患者出生前,多年从事核试验工作。家族中无同类病史及遗传病史。体检:身高168cm,指距170cm,体重49kg。外表未见异常,智力正常。无颈蹼、盾状胸、肘外翻等。乳房未发育,乳头极小,体毛及阴毛稀疏。外阴幼女型,阴道狭窄,子宫发育不良约3×2×1cm大小、未触及卵巢。阴道粘膜上皮细胞涂片仅见少许基底层细胞。E_2<10pg/ml,LH 141.4mIu/ml,FSH 130.5mIu/ml。颅底蝶鞍照片未见异常。     

东北虎幼体血清酶含量的测定与分析

目的 测定东北虎幼体血液中8种血清酶含量,为东北虎的生长发育、繁殖及疾病诊治等积累数据,并为虎类亚种间遗传和进化关系等的研究提供参考。 方法 用HITCH 7600-20型全自动生化分析仪对13只东北虎幼体进行8种血清酶含量的测定。 结果 东北虎幼体血清中8种酶含量分别为：谷草转氨酶（AST）(29.31±5.88)IU/L,乳酸脱氢酶（LDH）(267.08±76.40)IU/L,羟丁酸脱氢酶（α-HBDH） (149.38±54.07)IU/L,谷酰转肽酶（GGT）(2.92±1.94)IU/L,肌酸激酶（CK）(284.77±132.02)IU/L,淀粉酶（AMY）(2 149.85±357.03)IU/L,肌酸激酶同工酶（CK-MB）(390.62±145.70)IU/L,乳酸脱氢酶同工酶（LDI）(11.11±7.08)IU/L。 结论 东北虎幼体雌雄个体间所测8种血清酶含量无显著差异,与同科动物猎豹、金钱豹比较在AST、LDH等酶类存在差异。     

46,XX男性综合征一例

患者社会性别男,27岁,已婚3年未孕来我院附院就诊,自述性生活正常。查体:表型男性,身高170cm,体重60kg,智力正常,男性心理。皮肤稍粗糙,皮下脂肪较丰满,有胡须及喉结,男性嗓音,双侧乳房未发育。阴毛呈女性分布,阴囊发育尚可,阴茎小,能勃起。双侧睾丸约为1cm×1cm×1cm,质地坚韧。B超检查未见子宫及卵巢等女性内生殖器。3次精液常规:量3.6~4.0mL,pH值6.5~6.7,无精子。直肠指检前列腺无异常。血清性激素和促性腺激素测定:LH9.82U/L(正常值1.1~8.2U/L),FSH21.16U/L(正常值1.5~11.5U/L),T0.56ng/mL(正常值>2.5ng/mL),PRL160.4IU/mL(正…     

新兵训练后功能性闭经女兵的心身症状与激素水平

目的:探讨新人伍女兵功能性下丘脑性闭经(FHA)者与月经正常者激素水平及心理健康状况的差异。方法:在某部队新人伍女兵98人接受了为期近4个月的体能训练之后,有54人出现闭经.其中闭经3个月以上者有35人(研究组)。训练后月经正常、在采血时月经周期处于第5～11天者有26人(对照组)。分别测定她们血清中的促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E_2)、孕酮(P)、泌乳素(PRL)、睾酮(T)、ACTH、T_3、T_4的水平,并用SCL-90分别评定她们的心理健康状况。结果:FHA 者血清FSH 值为4.96±1.73 mIU/ml,LH 值为2.63±1.78 mIU/ml,E_2的值为7.23±5.37 pg/ml,对照组血清相应值为10.73±2.30mIU/ml、12.31±2.15mIU/ml、41.67±6.13pg/ml,差异有统计学意义(P<0.01),闭经组低于对照组。FHA 组SCL-90的躯体化、人际敏感、抑郁、焦虑及其他因子分大于2的比率分别为:51.4%、42.9%、48.6%、51.4%及37.1%;而对照组这5项分值大于2的比率分别为15.4%、15.4%、19.2%、21.3%及11.5%,两组间这5个因子大于2的人数差异有统计学显著意义(P<0.05),闭经组高于对照组。结论:诊断为FHA 的女兵与月经正常女兵的激素水平有差异,闭经组心身症状的发生率也高于对照组。     

男性不育患者中Y染色体微缺失与生殖激素水平的相关性分析

目的筛查严重少精子症及无精子症患者Y染色体AZF区域微缺失的发生情况,探讨Y染色体微缺失患者与生殖激素水平的关系。方法对138例男性不育患者(其中无精子症患者86例,少精子症患者52例)进行Y染色体无精子因子(azoospermia factor,AZF)微缺失分析,同时用化学发光法测定生殖激素水平。结果 138例患者中发生AZF微缺失患者7例,检出率为5.04%,其中严重少精子症3例,无精子症4例。7例AZF微缺失情况:AZFb区缺失3例;AZFb+c区缺失4例。Y染色体AZFb区缺失患者的卵泡刺激素(FSH)值(53.36±41.59)m IU/m L及AZFb+c区患者的卵泡刺激素(FSH)值(39.16±20.14)m IU/m L显著高于无Y染色体AZF区缺失患者(13.7±10.62)m IU/m L,Y染色体AZFb区缺失患者的促黄体生成素(LH)值(19.41±12.52)m IU/m L及AZFb+c区患者的促黄体生成素(LH)值(16.66±6.78)m IU/m L显著高于无Y染色体AZF区缺失患者(6.29±3.94)m IU/m L,Y染色体AZFb区缺失患者的睾酮(T)值(1.75±0.75)ng/m L及AZFb+c区患者的睾酮(T)值(3.80±1.99)ng/m L显著低于无Y染色体AZF区缺失患者(5.53±1.90)ng/m L,差异具有统计学意义(P0.05)。结论在无精子症及严重少精子症患者中Y染色体微缺失以AZFb区与AZFc区缺失最为常见。Y染色体AZFb+c区缺失是与FSH、LH和睾酮水平变化密切相关。     

性腺轴激素分泌的节律性变化及临床意义

目的探讨性腺轴激素的节律性变化规律及其对临床诊断治疗的指导意义.方法采用Beckman-Coulter ACCESS全自动微粒子化学发光免疫分析系统,分别测定了30例健康成年男性上午8点和下午4点的血清催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)和睾酮(T)的水平,并将不同时间段的结果分别进行配对t检验分析.结果 PRL 和T的血清水平上午8点均显著高于下午4点(P＜0.01),而E2、LH和FSH血清水平在这两个时间段没有显著性差异(P＞0.05).结论部分性腺轴激素在1天的不同时间段有波动,尤其是PRL和T,建议临床上对性腺轴激素的监测应采集同一时间段的标本进行分析.     

PRL细胞腺瘤过度分泌对促性腺激素水平及性腺功能的影响

利用ＲＩＡ测定ＰＲＬ细胞腺瘤患者血清中ＰＲＬ，ＦＳＨ，ＬＨ，Ｔ水平，探讨ＰＲＬ细胞腺瘤过度分泌ＰＲＬ对促性原激素以及对男性性功能的影响。结果在３６６例ＰＲＬ细胞腺瘤患者中，１５９例，血清ＦＳＨ水平低于正常，１４８例，血清ＬＨ水平低于正常，８例血清ＦＳＨ水平高于正常，１０例血清ＬＨ水平高于正常。     

Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Müllerian Hormone Levels in Normo-ovulatory Women

Serum anti-Müllerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.     

Modulation of folliculogenesis and steroidogenesis in women by graded menotrophin administration

BACKGROUND: To test the effects of progressively decreasing dosages of exogenous LH we combined various amounts of HMG, containing FSH, LH and HCG, and highly purified (HP) FSH to treat 120 GnRH agonist-suppressed infertile female patients as candidates for controlled ovarian stimulation (COS). METHODS: Subjects were randomly assigned to four treatment groups that received the following daily i.m. gonadotrophin regimens: A, FSH 150 IU only; B, FSH 150 IU and LH activity 37.5 IU; C, FSH 150 IU and LH activity 75 IU; D, FSH 150 IU and LH activity 150 IU. FSH dose adjustments were allowed only after the 14th treatment day. Monitoring included transvaginal ultrasound at 2-day intervals and daily determinations of LH, FSH, estradiol (E(2)), progesterone, testosterone and HCG. RESULTS: Duration of COS was significantly shortened in patients receiving at least 75 IU daily of LH activity. Small (<10 mm diameter) pre-ovulatory ovarian follicle occurrence was inversely correlated with LH activity dose administered (r = -0.648, P < 0.0001) and serum HCG levels (r = -0.272, P < 0.01) but not to serum LH levels. Serum testosterone levels were positively correlated to the LH activity dose administered (r = 0.313, P < 0.001), while serum progesterone levels were positively correlated to the FSH dose administered (r = 0.447, P < 0.00001) but not to the LH activity dose administered. CONCLUSIONS: Firstly, HCG content considerably contributes to HMG activity; secondly, menotrophin LH activity content can reduce in a dose-dependent manner the occurrence of small pre-ovulatory follicles; and finally, contrary to common belief, enhanced FSH stimulation rather than LH activity appears to cause premature follicle luteinization during COS.     

FSH and LH pituitary reserve and output in the postmenopause

FSH and LH basal levels and their cumulative responses following LH-RH administration were determined along with plasma estradiol levels in postmenopausal patients.89 postmenopausal patients were studied. They were divided into four groups according to the time elapsed since their menopause. Group I being less than 2 yr postmenopausal, Group II between 2 and 5 yr, Group III 5–10 yr and Group IV 10 yr or more postmenopausal.Blood was drawn before a bolus intravenous injection of 100 μg of LH-RH was given and at different time intervals after the injection.FSH, LH and plasma estradiol were assayed. FSH and LH cumulative responses after LH-RH (CR) and total cumulative respones (TCR), as defined by the surface area comprised between the tracing and a horizontal line drawn through the basal level (CR) or the X-axis (TCR) were calculated by planimetry.The basal levels of FSH tend to increase with age, with a maximum in the 3rd age group and a decline thereafter. A similar trend, though less outspoken, was seen in the LH basal levels. FSH cumulative responses after LH-RH (as expressed by the mean increment (Δ), maintained over the 2 h duration of the test) were significantly lower than the corresponding FSH basal levels and appeared to remain at the same level throughout postmenopause. In contrast, LH cumulative responses after LH-RH, expressed in the same way, compared with corresponding LH basal levels. They were highest in the younger age group, associated with still appreciable estradiol levels and declined in the subsequent age groups. LH-TCR and the LH-TCR: FSH-TCR ratio showed a similar trend as LH cumulative responses. It is suggested that this peculiar pattern, is related to estradiol levels.     

The effects of anterior hypothalamic deafferentation on FSH-releasing activity in the intact female hamster

Summary To study the role of the anterior hypothalamic area (AHA) in the control of the estrous (E) rise of follicle stimulating hormone (FSH), female hamsters were subjected to anterior hypothalamic deafferentation (D) or sham deafferentation (S) on 1500 h of proestrus (P). Serum levels of FSH and luteinizing hormone (LH) were measured by radioimmunoassay and FSH and LH releasing activities measured by bioassay in the anterior (AH) and medial basal hypothalamus (MBH) at several time periods during P and E. D did not affect serum levels of LH, whereas there was an attenuation of FSH levels during P and E. D caused an increase in FSH releasing activity in the AH within 1 h, while LH releasing activity was elevated 8 h after D. In animals with D, LH releasing activity in the MBH was elevated during P and was similar to controls during E. FSH releasing activity in the MBH increased during early E and dropped precipitously by 1400 h of E. Collectively, these data demonstrate dichotomous changes in FSH and LH releasing activities and provide further evidence for dual control mechanisms for these two gonadotropins.Supported in part by NIH grant RR-5417     

Gonadal function in patients with Down syndrome

Gonadal function was evaluated in 100 home-reared persons with Down syndrome (DS) including 53 boys and men and 47 girls and women. In order to definitively evaluate gonadal function in our subjects, all patients with abnormal thyroid function were excluded from endocrine analysis. Among the men, the frequency of hypospadias and cryptorchidism was similar to that of the general population. In both men and women, the ages for the onset and completion of puberty were also normal. However, among adult men with DS, the mean stretched penile length and the mean testicular volume were significantly below the mean value of normal men. In the 23 men with DS, the mean serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were significantly elevated above the mean for normal men. By contrast, the mean plasma level of testosterone (T) was normal, suggesting a diagnosis of partial gonadal deficiency. Among the 14 women in the study, 6 had primary gonadal dysfunction. In prepubertal children, serum FSH levels in 3 boys and 5 girls were more than 2 SD above the mean for normal children, while serum levels of LH in 3 boys and 2 girls were abnormally elevated. When gonadal function was evaluated in male infants, serum levels of FSH were above the normal in 6 of 11 subjects. Serum LH was abnormally elevated in 3 of 8 female infants. Our data argue that primary gonadal deficiency is common in DS, that it is progressive from birth to adolescence, and that it is clearly manifest in adult patients.     

Human pituitary gonadotropic adenoma; histological,immunocytochemical, and ultrastructural and hormonal studies in eight cases

Among 230 surgically removed pituitary adenomas, eight tumours showing immunostaining gonadotropic cells and elevated intratumours gonadotropin concentrations have been detected (frequency: 3°5 per cent.). By light microscopy the tumours were composed of agranular cells and generally PAS negative cytoplasm. The immunofluorescence technique revealed the presence of immunoreactive FSH (β-subunit) alone in two cases, of both FSH and LH in six cases with immunoreactive β endorphin in two of them. By electron microscopy, the cells contained an often dilated moderately or well developed rough endoplasmic reticulum, secretory granules measuring 150 nm to 200 nm which varied in electron density, and numerous microtubuls. Basal plasma FSH and LH levels were simultaneously elevated in two cases; FSH levels alone were elevated in two cases; in three cases, both FSH and LH plasma values were normal. FSH and LH intratumour concentrations were simultaneously elevated in five cases; FSH alone was elevated in two cases. In all cases, the concentrations of the other hormones were negligible, except in two cases where β endorphin concentration was elevated. The comparison of the immunocytochemical findings, the hormonal plasma levels and intratumour concentrations showed a good relationship between the immunoreactivity of the tumour and the intratumour RIA. The gonadotropic adenoma is uncommon but not rare. Its diagnosis is possible if immunocytochemical techniques are applied.     

An Unusual Hormone Pattern in a Virilized Woman Affected by Sertoli-Leydig Cell Tumor

A 24 year old woman was admitted to hospital because of hirsutism, virilism and amenorrhea, which had appeared 6 months earlier. Endocrinological evaluation showed a slightly elevated serum level of testosterone (1.2 ± 0.05 ng/ml), normal plasma levels of dehydroepiandroste-ronesulfate (DHEA-S) (2,070 ± 6 ng/ml), androstenedione (1.8 ± 0.5 ng ml) and sex hormone-binding globulin (SHBG)(42 ± 3nM/L); there was normal urinary 17 keto-steroid (17-KS) excretion (11.7 mg 24 h), low urinary estrogen (E) excretion (3 + 0.4//g 24 h), suppressed basal gonadotropin concentrations (LH 0.9//III ml; FSH 3.2,uUI/ml) and an exaggerated response to the LH RH test. At laparotomy, a monolateral ovarian tumor was found, which was proved histologically to be a Sertoli-Leydig cell tumor. After tumor ablation, a regular menstrual cycle followed and progressive reduction of virilism was noted. This was followed within 4 months by complete normalization of LH, FSH, estrogen and progesterone serum levels. The responsiveness to LH RH also became normalized. Two years after this operation, the patient had a normal pregnancy. This case of virilization in a woman affected by a benign Sertoli-Leydig cell tumor was primarily characterized by an unusual response of the hypothalamo pituitary axis against an endocrinological background of notable alteration of the androgen/estrogen ratio, where the androgens were slightly increased and the estrogens greatly reduced. Acta Pathol Jpn 39: 755-758, 1989.     

探讨铅暴露对女性FSH、PRL、LH等激素水平的影响

目的初步探讨低水平铅暴露对女性血清性激素及月经周期的影响。方法对铅暴露女性269人及对照组女性348人的一般情况、生殖结局进行回顾性队列研究,并测血铅及用放射免疫法测定孕酮（P）、雌二醇（E2）、催乳素（PRL）、卵泡刺激素（FSH）、黄体生成素（LH）性激素水平。结果暴露组女性月经紊乱明显高于对照组（P〈0．01）,且早产率、自然流产率亦高于对照组,差异有统计学意义（P〈0．01）;暴露组血清性激素水平孕酮（P）、雌二醇（E2）降低,促卵泡素、促黄体生成素升高。结论说明长期低浓度铅暴露干扰下丘脑一垂体～卵巢轴正常的内分泌调节功能,可引起女性月经失调、影响内分泌激素水平。