男性性腺功能低减病人尿β-FSH排泄连续测定

目的 :连续观察男性性腺功能低减病人尿卵泡刺激素 β亚单位 (β FSH)的排泄 ,探讨其对男性性腺功能低减的临床分类诊断和病理生理机制研究的意义。　方法 :4例健康成年男性 (年龄分别为 19、2 2、2 7、33岁 )、4例低促性腺激素型性腺功能低减男性病人 (年龄分别为 17、17、19、2 4岁 )和 5例高促性腺激素型性腺功能低减男性病人 (年龄分别为 16、16、17、2 0、2 2岁 ) ,连续留晨尿 30～ 32d ,其中 1例正常男性留取标本 6 3d。酶免法测定尿 β FSH ,以肌酐 (Cr)含量进行校正。　结果 :4例正常成年男性尿 β FSH总平均为 (1.16± 0 .2 0 ) μg/mgCr,均可出现波峰 ,最大峰值为 2 .76 μg/mgCr。 4例低促性腺激素型性腺功能低减男性病人 [Kallmann或特发性低促性腺激素型性腺功能低减 (IHH) ]尿 β FSH分别为 (0 .5 8± 0 .31)、(0 .93± 0 .4 7)、(0 .4 7± 0 .33)、(0 .6 0± 0 .4 0 ) μg/mgCr,曲线上未见明显波动。 5例高促性腺激素型性腺功能低减男性病人 (Klinefelter)尿 β FSH分别为 (3.0 2± 0 .93)、(4.36± 1.12 )、(4.79± 0 .78)、(4.6 4± 1.4 2 )、(3.88± 1.4 2 ) μg/mgCr,曲线上出现显著不规则波动 ,最大峰值达6 .83μg/mgCr。所有病人第二性征发育差 ,血清T水平显著低下。低促性腺激素?

Continuous Measurement of Urine β-FSH Excretion in Men with Hypogonadism

OBJECTIVES: To measure continuously the urine beta-FSH excretion in the patients with male hypogonadism, and to evaluate the significance of urine beta-FSH when used in the clinical practice and pathophysiological study on male hypogonadism. METHODS: Four health male volunteers (aged 19, 22, 27 and 33 years), four patients with the hypogonadotropic hypogonadism (aged 17, 17, 19 and 24 years) and five patients with idiopathy hypogonadism (hypergonadotropic, aged 16, 16, 17, 20 and 22 years) were asked to collect their morning-first urine samples for 30 to 32 days. One normal men collected his urine samples for 63 days. The urine beta-FSH was assayed with the method of EIA, then corrected by creatinine (Cr) concentration. RESULTS: The urine beta-FSH level of normal men was (1.16 +/- 0.20) micrograms/mg Cr, with the peak variation in their curves, peak level at 2.76 micrograms/mg Cr. The levels of urine beta-FSH of 4 patients with the hypogonadotropic hypogonadism were lower significantly than those of normal men [(0.58 +/- 0.31) (0.93 +/- 0.47) (0.47 +/- 0.33) and (0.60 +/- 0.40) micrograms/mg Cr], without fluctuation in their curves. beta-FSH levels of 5 patients with idiopathy hypogonadism were higher significantly [(3.02 +/- 0.93), (4.36 +/- 1.12), (4.79 +/- 0.78), (4.64 +/- 1.42) and (3.88 +/- 1.42) micrograms/mg Cr], with irregular fluctuation, the highest peak level at 6.83 micrograms/mg Cr. The second sexual characteristics of hypogonadal patients were poor and serum testosterone levels low. CONCLUSIONS: The urine beta-FSH level raised with irregular fluctuation in patients with idiopathy hypogonadism, while lowed without any fluctuation in patients with the hypogonadism. These findings suggested that the urine beta-FSH excretion was useful for the clinically classified diagnoses and pathophysiological study on male hypogonadism, and for observing the treatment reaction of androgen replacement.