男性尿毒症患者性腺轴系功能变化的研究

本文采用放免法测定23例 HD 治疗男性尿毒症患者的外周血性激素浓度,同时作了LHRH 兴奋试验,并与正常参照组比较.结果:①尿毒症组 T、E_2显著低于正常参照组,LH、FSH及 E_2/T 显著高于正常参照组(均P<0.01);⑦注射 LHRH 后,患者组 LH、FSH 均有升高反应,但有峰值延迟出现和延迟下降现象;③BUN 与 T、E_2呈显著负相关(r=-0.453,P<0.05和r=-0.705,P<0.01);④患者组平均 PRL 显著高于正常参照组(P<0.01).提示尿毒症患者存在明显的性腺轴系功能障碍,尿毒症毒素及高 PRL 血症可能是重要的影响因素.

STUDY ON FUNCTION OF THE HYPOTHALAMIC-PITUITARY-GONADAL AXIS IN UREMIA MEN ON HEMODIALYSIS

The sexual hormones were evaluated with radio-immunoassay and the stimulation tests with exogenous LHRH were performed in 23 uremic men on hemodialysis.The results showed that:①The values of basal LH、FSH、PRLand E_2/T ratio increased significantly(P<0.01)but those of T、E_2 decreascd(P<0.05);②The initial response of serum LH and FSH to LHRH was within the normal range,but the subsequent decent was retarded;③ There were significantly negative correlations between blood urea nitrogen(BUN)and T or E_2levels(P<0.05 and P<0.01,respectively).The above data suggest that in uremic men on hemodialysis may exist severe dysfunction of the hypothalamic-pi-tuitary-gonadal axis.The circulating uremic toxins and hyperprolactinemia might play importan roles in this dysfunction.