服棉酚者和其他原因所致的无精症患者血中促性腺激素与甾体激素的变化

本文比较了正常男子(Ⅰ组)、各种无精症患者(包括棉酚服用者。Ⅱ组)、原因不明的无精症者(Ⅲ组)以及Klinefelter 综合征患者(Ⅳ)血浆中FSH、LH、PRL、T、E_2和F 的变化。结果所有无精症患者的平均FSH、LH 水平明显高于Ⅰ组(P<0.001),但PRL、T、E_2及F 的平均值与Ⅰ组无区别(P>0.05)Ⅱ、Ⅲ组患者FSH 水平升高者与正常者各为50%,其余各组明显高于正常。Ⅲ组的LH 及T/LH 比值仍在正常范围内,但T、E_2及F 的平均值升高,PRL 降低;其余各组LH 与FSH 平行升高,T 及T/LH比值明显低于Ⅰ组(P<0.001),但E_2、F 及PRL 则在正常范围内。本实验证实,避孕剂量的棉酚并不损害睾丸合成T 的功能。FSH 过高说明生精上皮损害过度。本文还提出了一些控制棉酚用量的客观指标。

COMPARISON OF CHANGES OF SERUM GONADOTROPINS AND STEROID HORMONES IN AZOOSPERMIC MEN CAUSED BY GOSSYPOL & OTHER FACTORS

The plasma FSH,LH PRL,T,E_2 and F levels were compared in normal men(groups Ⅰ),azoospermic men with different etiology including gossypol treatment(group Ⅱ),menwith uncertain diagnosis(groupⅢ),and men with Klinefelter's syndrome(group Ⅳ)to determine whether difference in the hormone changes and its extent,if any,could befound in the affected subjects.The results have shown that the average FSH,LH levels of all azoospermic men asa whole group(N=50)were significantly higher than those in normal men.(p<0.001).There was no significant difference in the PRL,T,E_2,F levels from the control group(p>0.05).It was interesting to notice that the extent to which the hormone changes wereobserved in different groups of the affected subjects varied markedly.Normal FSH levelswere found in groups Ⅱ & Ⅲ by 50% of patients in each,while FSH level in all of the restof the patients was markedly higher than those of groups Ⅰ.Ⅱ.Ⅲ.(p<0.001).Thechanges of serum LH concentration was paralleled with FSH in groups Ⅲ and Ⅳ,andan groups Ⅱ,both LH and T/LH ratio remained unchanged,but T,E_2 and Flevels were elevated and PRL was decreased significantly as compared with the normalcon trols.The patients of group Ⅲ and Ⅳ have shown a very low T and T/LH ratiolevels as compared with the control group and group Ⅱ.(p<0.001).It was concluded that the contraceptive dose of gossypol did not cause obvious damagein Leydig's cell function in terms of T production.The high FSH levels indicated thesevere damage of the germinal epithelium of the testis.In order to minimize side effectsand to avoid irreversibility in the spermatogenesis the minimal effective dose of gossypolmust be used as a contraceptive.Some objective reference parameters were recommendedto monitor the contraceptive dose of gossypol.