在ACTH依赖库希综合征的男性中长度评估生殖内分泌功能
Skand Shekhar1, Raven N McGlotten2, Gordon B Cutler3
1Reproductive Physiology and Pathophysiology Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
The Journal of clinical endocrinology and metabolism
|July 16, 2024
概括
在患有库辛综合征 (CS) 的男性中,阴性腺缺陷是常见的,但在手术后通常会有所改善. 大约75%的患者在一年内恢复丸功能,这表明下丘脑GNRH抑制是关键因素.
科学领域:
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
- 手术内分泌学手术内分泌学
背景情况:
- 库希综合征 (CS) 可以导致阴性双胞胎缺陷症,恶化其影响.
- 评估阴性双胞胎症患有CS的男性的阴性双胞胎症患病率和原因至关重要.
研究的目的:
- 确定CS.手术治疗前和之后的男性阴性腺体缺陷症的频率.
- 在这个患者群体中调查下性的潜在原因.
主要方法:
- 对两个潜在的男性队列 (C1: n=8,C2: n=44) 的特异分析,这些男性患有依赖ACTH的CS.
- 激素评估 (LH,FSH,丸激素,甲状腺激素,皮质醇) 和手术前和后的GNRH刺激测试.
- 在基线和手术后6-12个月治疗后评估阴道腺的频率.
主要成果:
- 82%的患者患有基线性阴性腺症,51%的患者在手术后6个月仍然患有阴性腺症,12个月后降至26%.
- 手术后,和LH水平显著增加.
- 甲状腺激素水平与皮质醇相反相关,而阴性双胞胎症似乎是由下丘脑GNRH抑制介导的.
结论:
- 在CS中,男性阴性双胞胎症的发病率很高,但在成功手术后的一年内,在很大程度上是可逆的.
- 通过手术治愈CS,可以恢复丸功能,一年后恢复率约为75%.
- 在CS中,阴性腺缺陷与GnRH抑制有关,并受到甲状腺激素状况的影响.
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