尿毒症患者的性激素变化及其临床意义探讨

目的 :探讨女性尿毒症患者卵巢功能障碍的发病情况及其临床意义。方法 :应用酶免疫法 (EIA)测定了2 3例更年期前女性尿毒症非透析患者、15例透析患者及 2 9例健康献血者中促卵泡素 (FSH)、泌乳素 (PRL)、促黄体素 (LH)、雌二醇 (E2 )及孕酮 (P)的水平。结果 :尿毒症女患者PRL、FSH及LH均较健康对照组升高 ,而孕酮值显著降低 ,对此均有显著差异 ;且尿毒症女患者PRL升高、孕酮值降低与肾小球滤过率 (GFR)呈明显相关。透析患者较非透析患者PRL升高更为明显 ,孕酮值亦较非透析患者有所升高 ,但无显著意义。结论 :尿毒症女患者的排卵障碍及月经紊乱等都与尿毒症的严重程度相平行。透析并不能改善尿毒症女患者的卵巢功能障碍 ,只有纠正与改善肾功能 ,才能使尿毒症女患者的卵巢功能得以改善

CHANGES OF SEX HORMONES IN UREMIC PATIENTS AN ITS CLI NICAL SIGNIFICANCE

Objective:To investigate the pathogenisis, the position and the mechanism of ovarian dysfunction in patients with uremia. Methods:Blood from 23 cases of non-dialysed and 15 dialysed patients with uremia and 29 normal controls were tested for sex hormones (FSH,PRL,LH,E 2 and P). Results: FSH,PRL,LH and E 2 in all patients were increased, while the progesterone was decreased. Although there was no statistical significance between dialysed and non-dialysed patients, progesterone and PRL levels showed an increase in dialysed patients. The increased level of PRL showed a negative correlation with GFR.Conclusions:The severity of ovulation disturbance and menstrual disorder of the patients parallels with the severity of the disease. Dialysis can not improve the ovarian function. Only when the function of kidney was corrected, could the ovarian function be improved.