不同时期不孕症患者体内激素水平变化及临床意义

目的探讨不同时期不孕症患者体内激素水平变化及临床意义。方法将首都医科大学附属北京妇产医院自2015年1月至2016年12月收治的获得明确诊断的96例不孕症患者设为不孕症组,其中,卵泡期32例,排卵期29例,黄体期35例。同时,选取同期健康体检者100例为健康组,其中,卵泡期35例,排卵期34例,黄体期31例。检测所有受试者的卵泡雌激素、黄体生成素、雌二醇、垂体泌乳素、孕酮、睾酮水平,并对检测结果进行比较分析。结果不孕症组卵泡期患者卵泡雌激素、雌二醇、垂体泌乳素、孕酮、睾酮水平与健康组比较,差异有统计学意义(P<0.05);排卵期患者卵泡雌激素、黄体生成素、雌二醇、孕酮、睾酮水平与健康组比较,差异有统计学意义(P<0.05);黄体期患者黄体生成素、垂体泌乳素、孕酮水平与健康组比较,差异有统计学意义(P<0.05)。结论性激素水平的变化与不孕症的发生存在密切联系,展开血清性激素水平检测,对于不孕症的诊断具有重要意义,临床价值显著,值得关注并推广。     

女子篮球运动员运动能力与月经周期中性激素水平关系的研究

本研究通过监测１８名女子篮球运动员月经周期不同时相中进行大强度（５０分钟ＨＲ１８０～２００次／分）及中等强度（２小时ＨＲ１２０～１６０次／分）训练课后雌二醇（Ｅ２），孕酮（Ｐ），睾酮（Ｔ）及促卵泡激素（ＦＳＨ），黄体生成素（ＬＨ）水平的变化，探讨运动能力与性激素水平的关系。主要结果：大强度专项训练课后受试者血清Ｅ２，Ｐ水平在卵泡，黄体及月经期均明显升高；Ｔ表现为卵泡，黄体期升高，而月经期下降；ＦＳＨ仅在卵泡期升高；ＬＨ则在各期均未见显著改变。中等强度专项训练课后，Ｅ２，Ｐ，Ｔ及ＦＳＨ在各时相均明显升高，ＬＨ无明显变化。课后２４小时各种激素水平基本恢复至课前状态。结果提示：运动中女性激素的升高是机体对运动刺激出现的的一种自我保护性反应。女篮运动员机体运动能力与月经周期不同时相运动中性激素水平的变化密切相关。     

严重急性呼吸综合征患者血清性激素水平的测定和评价

目的　观察严重急性呼吸综合征 (SARS)患者性腺是否受到损害。方法　采用电化学发光免疫技术检测 6 6例男性SARS患者的血清雌二醇 (E2 )、孕酮 (PROG)、促卵泡激素(FSH)、黄体生成素 (LH)和催乳素 (PRL)水平 ,并与 40名健康对照者进行比较。结果　SARS患者血清E2、PROG含量明显低于对照组 (P <0 0 1) ,FSH、LH和PRL含量明显高于对照组(P <0 0 1)。重型SARS患者血清E2含量显著低于普通型。激素水平恢复要慢于临床症状的改善。结论　SARS患者中性激素含量异常 ,提示性激素水平改变有可能是SARS发病过程中的环节之一 ,SARS病程中性激素水平的恢复可能是一个缓慢的过程。     

颅脑损伤后T淋巴细胞亚群及性激素的动态变化

目的　探讨T淋巴细胞亚群及性激素变化在脑损伤中的作用。　方法　对 10 1例急性颅脑损伤患者血中CD4 + 、CD8+ T淋巴细胞及血清和脑脊液中雌二醇、孕酮和睾酮分别在伤后<12h、1,3,7d进行动态观察及相关分析。　结果　伤后各组CD4 + 、CD8+ T淋巴细胞均受抑制 ,并随损伤程度而加重 ;各组伤后 12h内血清、脑脊液内雌二醇和孕酮升高 ,而格拉斯哥昏迷评分 (GCS)≤ 8分组雌二醇伤后 1d和 3d、孕酮 7d内持续增高 ,与其他各组比较差异有显著性意义或非常显著性意义 (P <0 .0 5 ,0 .0 1) ;死亡组血清、脑脊液内睾酮降低 ,GCS≤ 8分组脑脊液内睾酮升高 ;死亡组中CD4 + T淋巴细胞变化与雌二醇、孕酮及睾酮均呈正相关。　结论　颅脑损伤后早期雌二醇及后期孕酮增高对脑组织有一定的保护作用 ;T淋巴细胞及性激素减少是患者死亡的重要因素。     

中老年男性内分泌激素水平与骨质疏松的相关性研究

男性骨质疏松的病因是多方面的，雄激素水平下降是重要因素之一。雄激素不仅在获得骨峰值及维持骨量中起重要作用，而且雄激素水平下降与增龄骨丢失密切相关。为进一步探讨中老年男性内分泌激素与骨质疏松的关系，本文对65例病人进行了血清雌二醇（E2）、睾酮（T）、促黄体生成素（LH）、促卵泡生成素（FSH）、泌乳素及孕酮的检测和骨密度测定，并进行相关性分析。     

子宫肌瘤动脉栓塞治疗:对卵巢功能的影响及血清性激素的变化

目的:探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤对月经和卵巢功能的影响。方法:66例子宫肌瘤行UAE后随访3～33个月,观察月经变化,其中15例在preUAE和postUAE3个月,监测血清黄体生成素(LH)、卵泡刺激素(TSH)、泌乳素(PRL)、孕酮(Prog)、雌二醇(E2)等5种性激素变化。结果:47例(81%)UAE后恢复正常月经或明显改善,5例(8.6%)有一过性月经紊乱,3例(5.2%)出现闭经(年龄>45岁)。14例血清5种性激素在preUAE和postUAE变化差异无显著性意义(P>0.05),1例(年龄46岁)5种性激素preUAE处于卵泡期水平,postUAE3月处于绝经期。结论:UAE治疗子宫肌瘤后,大部分患者可恢复正常月经,对卵巢功能影响小,对血清性激素水平无明显影响,但极少数年龄大于45岁者postUAE可出现闭经。     

回阳玉龙膏联合磁、热疗对乳腺增生大鼠的影响

目的 研究回阳玉龙膏联合磁、热疗对实验性大鼠乳腺增生症治疗作用.方法 应用苯甲酸雌二醇黄体酮建立大鼠乳腺增生模型.回阳玉龙膏联合磁、热疗干预30天,第31天测量大鼠乳头的直径以及高度,测定肝功能、肾功能、雌二醇(E2)、孕酮(P),泌乳素(PRL)水平,另取大鼠心胜以及乳腺行病理学检测,观察大鼠乳腺导管变化情况.结果 ...     

血清性激素与5-羟色胺在女性围绝经期抑郁患者体内的表达

目的观察血清性激素与5-羟色胺在女性围绝经期抑郁患者体内的表达水平。方法检测48例女性围绝经期抑郁患者血清卵泡刺激素（FSH）、雌二醇（E）及5-羟色胺（5-HT）的表达水平。同期选择健康体检妇女45例作为对照组进行检测。结果观察组血清卵泡刺激素（FSH）水平明显高于对照组（P〈0．05）,而血清雌二醇（E）和5-羟色胺（5-HT）表达水平明显低于对照组（P〈0．05）。结论女性围绝经期抑郁患者体内雌激素水平明显下降,负反馈性升高卵泡刺激素,并导致5-羟色胺表达水平显著下降。     

不同强度运动对女子游泳运动员性激素水平的影响及特点

本研究以放兔分析法观察不同强度运动前后19名女子游泳运动员血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、孕酮(P)、睾酮(T)及胰岛素(Ins)的变化。受试者在卵泡及黄体两期分别进行短时间高强度间歇运动——6×50m全速力竭性游泳和长时间持续运动——1000m全速力竭性游泳。在运动前5分钟及运动后即刻分别采集静脉血测定各种激素含量。主要结果如下:受试者从事6×50m最大速度间歇游泳后,卵泡期各种激素浓度的变化均显著高于运动前安静状态,黄体期变化不一,FSH、LH降低,E_2、P、T及Ins升高。从事1000m全速游泳后,激素变化表现为卵泡期FSH、LH、E_2、P均升高,T及Ins降低;黄体期E_2、P、T升高,Ins降低,FSH、LH无显著变化,两期相比黄体期运动成绩优于卵泡期。上述结果提示:①受试者月经周期的黄体期机体有氧能力强于卵泡期,运动能力的增强与黄体期E_2、P、T水平升高有关。②FSH、LH与E_2、P分泌变化并非同步一致,说明运动中E_2升高并非受制于促性腺激素,而主要是卵巢分泌量升高所致。③运动中E_2、P、T具有协同效应,可抵抗疲劳,提高人体运动能力。     

女性性激素与血脂谱、丙二醛、超氧化物歧化酶及淋巴细胞亚群的相关性研究

目的 探讨女性血清性激素水平变化及其与血脂谱、丙二醛(MDA)、超氧化物歧化酶(SOD)及T淋巴细胞亚群的关系。方法 健康女性志愿者1185例，用放射免疫分析法测定性激素；用全自动生化分析仪测定血脂谱及载脂蛋白(Apo)；用流式细胞仪测定T细胞亚群；用硫代巴比妥酸法和Oyanagui亚硝酸盐形成法分别测定血清MDA和SOD．结果 女性促卵泡激素(FSH)、促黄体生成素(LH)绝经后明显增加；垂体泌乳素(PRL)绝经后升高，17β-雌二醇(17β-E2)、孕酮(P)绝经后明显下降，17β-E2/P比值绝经后明显降低。睾酮(T)绝经后明显增加，游离睾酮(FT)则在70岁后明显升高。女性70岁后血清总胆固醇(TC)明显升高，甘油三脂(TG)绝经后明显升高；高密度脂蛋白胆固醇(HDL-C)绝经后降低，低密度脂蛋白胆固醇(LDL-C)70岁后明显升高，HDL-C／TC和HDL-C／LDL-C绝经后降低，70岁后ApoA—I降低，ApoB则在42～59岁组明显升高，ApoA-I/ApoB比值绝经后明显下降。CD3^ 、CD4^ 在60岁前变化不明显，60岁后CD3^ 下降，CD4^ 明显降低，CD8^ 绝经后各组与对照组相比无变化，CD4^ ／CD8^ 比值随增龄降低明显。MDA在70岁后明显升高，SOD60岁开始明显下降。对绝经后17β-E2按四分位数(15．66、27．05、57．80pmol／L)进行分层，比较各项指标的变化，结果示随血清17β-E2水平降低，HDL-C、HDL-C／TC、HDL-C／LDL-C、SOD、CD3^ 、CD4^ 及CD4^ ／CD8^ 降低，差异有显著性，TG、LDL-C、ApoB则增高。结论 老年女性血脂谱、细胞免疫功能及氧化，抗氧化系统的变化可能与性激素失衡有关，提示性激素在机体衰老过程中起重要作用。     

Influence of the menstrual cycle phase and menstrual symptoms on maximal anaerobic performance

PURPOSE: This study was designed to analyze the effect of the menstrual cycle phase on maximal anaerobic performance during short-term anaerobic tests. METHODS: Seven eumenorrheic women (NOC) and 10 women using monophasic oral contraceptives (OC) performed three anaerobic tests (force-velocity, multi-jump, and squatting jump tests) during menstruation (M: between days 1 and 4), the midfollicular phase (F: between days 7 and 9), and the midluteal phase (L: between days 19 and 21) of the ovarian cycle. Follicular and luteal phases were confirmed by serum progesterone levels. The order of testing sessions was randomly assigned and a 15-min standardized warm-up preceded each testing session. Rectal temperatures were taken before (Trec(b)) and after (Trec(a)) warm-up. RESULTS: No significant differences were observed among M, F, and L in Trec(b), Trec(a) maximal cycling power (Pmax(c)), maximal jumping power (Pmax(j)), or maximal height of jump (h(j)) in either NOC or OC. Ten of the women suffered premenstrual or menstrual symptoms (MS); the other seven did not report any premenstrual or menstrual discomfort (NMS). Presence or absence of symptoms was not correlated with oral contraceptive use. No significant differences were observed among the three stages of the menstrual cycle in Pmax(c), Pmax(j), or h(j) in NMS. In MS, only Pmax(j) decreased by 8% in M compared with that in F (P < 0.05). CONCLUSIONS: Although there were no significant differences in maximal anaerobic performance during different menstrual cycle phases, results of this study suggest that the presence or absence of premenstrual or menstrual syndrome symptoms may have an effect, possibly through an action on the stretch-shortening cycle of tendons and ligaments.     

Menstrual disturbances in athletes: a focus on luteal phase defects

Subtle menstrual disturbances that affect the largest proportion of physically active women and athletes include luteal phase defects (LPD). Disorders of the luteal phase, characterized by poor endometrial maturation as a result of inadequate progesterone (P4) production and short luteal phases, are associated with infertility and habitual spontaneous abortions. In recreational athletes, the 3-month sample prevalence and incidence rate of LPD and anovulatory menstrual cycles is 48% and 79%, respectively. A high proportion of active women present with LPD cycles in an intermittent and inconsistent manner. These LPD cycles are characterized by reduced follicle-stimulating hormone (FSH) during the luteal-follicular transition, a somewhat blunted luteinizing hormone surge, decreased early follicular phase estradiol excretion, and decreased luteal phase P4 excretion both with and without a shortened luteal phase. LPD cycles in active women are associated with a metabolic hormone profile indicative of a hypometabolic state that is similar to that observed in amenorrheic athletes but not as comprehensive or severe. These metabolic alterations include decreased serum total triiodothyronine (T3), leptin, and insulin levels. Bone mineral density in these women is apparently not reduced, provided an adequate estradiol environment is maintained despite decreased P4. The high prevalence of LPD warrants further investigation to assess health risks and preventive strategies.     

Hormonal reaction of steroid-producing glands of female Papio to long-term hypokinesia

The endocrine function of steroid-producing glands of hamadryas baboon females exposed to 28-day clinostatic hypokinesia at different stages of the menstrual cycle was investigated. The adrenocortical response to hypokinesia developed in two phases: early stimulation was followed by inhibition of the adrenocortical activity which persisted during the subsequent period of hypokinesia and two weeks after exposure. The degree and duration of the activation effect of hypokinesia were determined by the initial phase of the menstrual cycle: the adrenocortical response during the follicular phase was higher than during the luteal phase. The hormonal function of ovaries was inhibited under the action of hypokinesia. The ovarian response was dependent on the initial phase of the menstrual cycle. Exposure to hypokinesia that began in the follicular phase resulted in a drastic reduction of estradiol while that started at the luteal phase led to a significant decline of progesterone. Monotonously low secretion of ovarian steroids was combined with desynchronosis of their circadian rhythms. Disorders in the function of steroid-producing glands during hypokinesia were transient.     

The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels

Anterior cruciate ligament injury rates are reported to be two to eight times higher in women than in men within the same sport. Because the menstrual cycle with its monthly hormonal fluctuations is one of the most basic differences between men and women, we investigated the association between the distribution of confirmed anterior cruciate ligament tears and menstrual cycle phase. Sixty-nine female athletes who sustained an acute anterior cruciate ligament injury were studied within 24 hours of injury at four centers. The mechanism of injury, menstrual cycle details, use of oral contraceptives, and history of previous injury were recorded. Urine samples were collected to validate menstrual cycle phase by measurement of estrogen, progesterone, and luteinizing hormone metabolites and creatinine levels at the time of the anterior cruciate ligament tear. Results from the hormone assays indicate that the women had a significantly greater than expected percentage of anterior cruciate ligament injuries during midcycle (ovulatory phase) and a less than expected percentage of those injuries during the luteal phase of the menstrual cycle. Oral contraceptive use diminished the significant association between anterior cruciate ligament tear distribution and the ovulatory phase.     

The effect of estradiol and progesterone on knee and ankle joint laxity

BACKGROUND: Female athletes suffer a higher incidence of anterior cruciate ligament injuries compared to their male counterparts, and they appear to be at increased risk for these injuries when they have increased anterior-posterior knee laxity and at specific phases of the menstrual cycle. Although the mechanism by which these factors combine to increase injury risk is unclear, studies suggest that cyclic variations in joint laxity produced by hormone fluctuation during the menstrual cycle predispose an athlete to increased risk of ligamentous injury. Little is known about whether joint laxity varies cyclically during the menstrual cycle and if so, whether it is modulated by cyclic variations of estradiol (E2) and progesterone (P4). HYPOTHESIS: Increased serum estradiol (E2) and progesterone (P4) levels are associated with increased ankle and knee joint laxity. STUDY DESIGN: Cohort study. Level of evidence, 2. METHODS: Ankle laxity, anterior-posterior knee laxity, and serum concentrations of estradiol (E2) and progesterone (P4) were measured during the menstrual cycle in women and at corresponding time intervals in men (controls). Ankle laxity was measured from stress radiographs and included anterior talar translation relative to the tibia and talar tilt relative to the tibia; anterior-posterior knee laxity was measured with the KT-1000 arthrometer. RESULTS: Women had greater knee and ankle laxity values compared to men. There was, however, no change in knee and ankle laxity over the normal menstrual cycle in women and no change over time in men. There was no relationship between estradiol and progesterone fluctuation and ankle and knee joint laxity. CONCLUSIONS: Knee and ankle joint laxities are greater for women compared to men; however, the cyclic estradiol and progesterone fluctuations that occur during the menstrual cycle do not produce cyclic fluctuations of joint laxity. Studies using joint laxity to identify a subject at risk for ligamentous injury need only consider making measurements at a specific point in time, such as during a preseason screening evaluation.     

不同月经周期赛艇和短跑运动员性激素水平和运动能力的观察

通过测定浙江省13名女子赛艇运动员和12名女子短跑运动员卵泡期和黄体期的性激素水平、运动成绩及完成定量负荷运动后的血乳酸水平,观察不同项目女运动员不同月经周期激素水平和运动成绩的变化,以探讨不同月经周期与运动能力的关系。研究结果显示:女子赛艇和短跑运动员黄体期的孕酮(P)和睾酮(T)水平显著高于卵泡期(P<0.05);赛艇运动员黄体期促卵泡激素(FSH)水平显著高于卵泡期(P<0.05),而运动员黄体期和卵泡期的雌二醇(E2)和促黄体生成素(LH)水平则无显著性差异。赛艇运动员黄体期500m测功仪成绩显著优于卵泡期(P<0.01),而2000m测功仪成绩两期无显著性差异;短跑运动员黄体期100m、200m成绩均显著优于卵泡期(P<0.05,P<0.01)。定量负荷运动后,赛艇和短跑运动员黄体期的血乳酸水平均显著低于卵泡期(P<0.05,P<0.01)。结果表明,受试运动员黄体期机能状态较好,这可能与不同月经周期中激素水平变化以及在运动状态下各种激素间的协同效应有关。提示对女运动员的生理周期应给予充分重视。     

Physiological responses to the menstrual cycle: implications for the development of heat illness in female athletes

Fluctuations in estrogen and progesterone during the menstrual cycle can cause changes in body systems other than the reproductive system. For example, progesterone is involved in the regulation of fluid balance in the renal tubules and innervation of the diaphragm via the phrenic nerve. However, few significant changes in the responses of the cardiovascular and respiratory systems, blood lactate, bodyweight, performance and ratings of perceived exertion are evident across the cycle. Nevertheless, substantial evidence exists to suggest that increased progesterone levels during the luteal phase cause increases in both core and skin temperatures and alter the temperature at which sweating begins during exposure to both ambient and hot environments. As heat illness is characterised by a significant increase in body temperature, it is feasible that an additional increase in core temperature during the luteal phase could place females at an increased risk of developing heat illness during this time. In addition, it is often argued that physiological gender differences such as oxygen consumption, percentage body fat and surface area-to-mass ratio place females at a higher risk of heat illness than males. This review examines various physiological responses to heat exposure during the menstrual cycle at rest and during exercise, and considers whether such changes increase the risk of heat illness in female athletes during a particular phase of the menstrual cycle.     

Effects of menstrual phase and amenorrhea on exercise performance in runners

There are few well controlled studies in terms of subject selection, menstrual classification, and exercise protocol that have examined both maximal and submaximal exercise responses during different phases of the menstrual cycle in eumenorrheic runners and compared these runners to amenorrheic runners. Thus, the purpose of this study was to measure selected physiological and metabolic responses to maximal and submaximal exercise during two phases of the menstrual cycle in eumenorrheic runners and amenorrheic runners. Eight eumenorrheic runners (29.0 +/- 4.2 yr) and eight amenorrheic runners (24.5 +/- 5.7 yr) matched for physical, gynecological, and training characteristics were studied. The eumenorrheic runners performed one maximal and one submaximal (40 min at 80% VO2max) treadmill run during both the early follicular (days 2-4) and midluteal (6-8 d from LH surge) phases. The amenorrheic runners performed one maximal and one submaximal (40 min at 80% VO2max) treadmill run. Cycle phases were documented by urinary luteinizing hormone and progesterone assays and by plasma estradiol and progesterone assays. No differences were observed in oxygen uptake, minute ventilation, heart rate, respiratory exchange ratio, rating of perceived exertion, time to fatigue (maximal), and plasma lactate (following the maximal and submaximal exercise tests) between the follicular and luteal phases in the eumenorrheic runners and the amenorrheic runners. We conclude that neither menstrual phase (follicular vs luteal) nor menstrual status (eumenorrheic vs amenorrheic) alters or limits exercise performance in female athletes.     

Substrate oxidation and GH responses to exercise are independent of menstrual phase and status.

The purpose of this study was to determine the extent to which growth hormone (GH) and energy substrate utilization are influenced by basal sex steroid levels during prolonged submaximal exercise across menstrual phase and status. Also the 17 beta-estradiol (E2) and progesterone responses during prolonged exercise were compared according to menstrual phase and menstrual status. Six amenorrheic (AMc) athletes and seven eumenorrheic (EUc) athletes ran at 60% VO2max for 90 min and serial blood samples were taken at rest, every 10 min throughout exercise, and 5 and 15 min post-exercise. The EUc athletes were tested in the early follicular phase (EF) (days 3-5), the late follicular phase (LF) (days 14-16) and the mid-luteal phase (ML) (days 22-25). The incremental GH response to exercise, measured by area under the curve, was consistent with previous reposts and was not altered according to menstrual phase or status (EF-37.5 +/- 11.5, LF-61.9 +/- 11.5, ML-48.1 +/- 12.8 micrograms.1-1.90 min-1). Furthermore, carbohydrate and fat utilization during exercise were not influenced by basal sex steroid levels associated with menstrual phase or status. The incremental E2 response to exercise in AMc athletes was significantly smaller than seen in EUc athletes (AMc-208.1 +/- 44.0, EF-383.0 +/- 116.4, LF-204.7 +/- 84.1, ML-45.1 +/- 18.4 pmol.1(-1).90 min-1), although the pattern of release is similar between groups. In conclusion, GH levels and substrate utilization are independent of both menstrual phase and status; hence, menstrual phase has no negative ramifications on metabolism during exercise. Amenorrhea does not result in metabolic consequences during prolonged exercise by influencing substrate utilization.