Pepperell R J, Brown J B, Evans J H, Rennie G C, Burger H G
Br J Obstet Gynaecol. 1975 Apr;82(4):321-32. doi: 10.1111/j.1471-0528.1975.tb00643.x.
Urinary oestrogen and pregnanediol excretion was measued daily ("daily monitoring") for a complete cycle in 20 normally menstruating women, in one patient with an anovulatory cycle and for 28 days in a patient with secondary amenorrhoea. The measurements were also performed on urine specimens collected at weekly intervals for 4 to 6 weeks ("weekly tracking") from 506 patients with evidence of abnormal ovarian function. These included 9 patients with primary amenorrhoea, 132 patients with secondary amenorrheoa, 138 patients with oligomenorrhoea and 227 patients with evidence of ovarian dysfunction and cycle lengths of 25 to 42 days. The results were subjected to statistical analysis. In the normal cycles, ovulation could be identified on the criteria of a rising pregnanediol value reaching or exceeding 2-0 mg. per 24 hours for a period of 7 days or more. Valid conclusions on the overall mean oestrogen and pregnanediol values for a complete cycle could be made from the results of weekly tracking, irrespective of which day the tracking commenced. Correlations were obtained by comparing the mean and maximum urinary oestrogen values and the variability of the values with the evidence of ovarian function indicated by the clinical classifications of the patients, the duration of the disorders and the subsequent occurrence of uterine bleeding. Mean oestrogen values of 10 mug. per 24 hours or less were associated with lack of ovarian function. For values higher than this a discriminant function based on both the mean oestrogen value and the variability of the oestrogen values was useful in predicting onset of spontaneous menstruation. A single urine specimen collected 4 to 8 days before onset of menstruation showing a raised pregnanediol value of 2-0 mg. per 24 hours or more provided a valid test for ovulation in women with regular cycles, and a single urine specimen giving an oestrogen value of 10 mug per 24 hours or less gave a valid indication of absent ovarian function in women with amenorrhoea for two years or more. In all other circumstances serial sampling at weekly intervals provided a valid assessment of ovarian activity. Application of these principles allows the greatest amount of information on ovarian function to be obtained with the greatest economy of effort.
对20名月经正常的女性进行了一个完整周期的每日尿雌激素和孕二醇排泄量测定（“每日监测”），对1名无排卵周期患者进行了同样测定，并对1名继发性闭经患者进行了28天的测定。还对506名有卵巢功能异常迹象的患者每隔一周收集的尿标本进行了测定（“每周追踪”），为期4至6周。这些患者包括9名原发性闭经患者、132名继发性闭经患者、138名月经过少患者以及227名有卵巢功能障碍且月经周期长度为25至42天的患者。对结果进行了统计分析。在正常周期中，根据孕二醇值升高至达到或超过每24小时2.0毫克并持续7天或更长时间的标准可确定排卵。无论追踪从哪一天开始，根据每周追踪结果都可得出关于一个完整周期的总体平均雌激素和孕二醇值的有效结论。通过比较尿雌激素的平均和最高值以及这些值的变异性与患者临床分类所表明的卵巢功能证据、疾病持续时间以及随后子宫出血的发生情况，得出了相关性。每24小时10微克或更低的平均雌激素值与卵巢功能缺乏相关。对于高于此值的情况，基于平均雌激素值和雌激素值变异性的判别函数有助于预测自然月经的开始。在月经开始前4至8天收集的单个尿标本显示孕二醇值每24小时升高至2.0毫克或更高，这为月经周期规律的女性提供了有效的排卵检测，而单个尿标本给出的雌激素值每24小时10微克或更低，则为闭经两年或更长时间的女性卵巢功能缺失提供了有效的指示。在所有其他情况下，每隔一周进行系列采样可对卵巢活动进行有效的评估。应用这些原则能够以最大的工作量节省获取关于卵巢功能的最多信息。
