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甲状腺功能亢进女性体内促性腺激素、雌激素和孕激素的血浆浓度

Plasma concentration of gonadotrophins, oestrogens and progesterone in thyrotoxic women.

作者信息

Akande E O, Hockaday T D

出版信息

Br J Obstet Gynaecol. 1975 Jul;82(7):541-51. doi: 10.1111/j.1471-0528.1975.tb00684.x.

Abstract

Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen and progesterone were measured daily in 15 thyrotoxic women in the reproductive age for 28 to 30 consecutive days before commencement of therapy and for a similar period following restoration of the euthyroid state. Five of these patients had secondary amenorrhoea whilst the other 10 had hypomenorrhoea. Twelve healthy volunteer eythyroid women of similar age and parity, with no history of menstrual abnormality, served as controls. The levels of both gonadotrophins (LH and FSH) and oestrogen were found to be significantly raised in all thyrotoxic patients in comparison with levels in the euthyroid female controls (P less than 0.001). "Mid cycle" LH and FSH peaks were present in thyrotoxic patients who were still menstruating whilst they were absent in those who developed amenorrhoea. Plasma oestrogen concentration rose to a peak on the day before the surge of LH (and FSH) in all euthyroid frmale controls as well as in thyrotoxic patients who were still menstruating. In contrast, oestrogen peaks occurred without ensuing LH (and FSH) peaks in thyrotoxic patients who had developed amenorrhoea, suggesting a failure of the positive feed-back mechanism. The levels and patterns of plasma progesterone in thyrotoxic subjects who were still menstruating were similar to those of euthyroid controls. However, no significant circulating plasma progesterone was detected in thyrotoxic subjects who were amenorrhoeic. The levels and patterns of all of these hormones (gonadotrophins, oestrogen and progesterone) became normal after restoration of euthyroid state and normal menstruation.

摘要

在15名育龄期甲状腺毒症女性开始治疗前连续28至30天每日测量血浆促黄体生成素(LH)、促卵泡生成素(FSH)、雌激素和孕酮水平,并在甲状腺功能恢复正常状态后的相似时间段内进行测量。其中5例患者继发闭经,另外10例月经过少。12名年龄和孕产情况相似、无月经异常病史的健康甲状腺功能正常的志愿者女性作为对照。与甲状腺功能正常的女性对照相比,所有甲状腺毒症患者的促性腺激素(LH和FSH)及雌激素水平均显著升高(P<0.001)。仍有月经的甲状腺毒症患者出现“周期中期”LH和FSH峰值,而闭经患者则未出现。在所有甲状腺功能正常的女性对照以及仍有月经的甲状腺毒症患者中,血浆雌激素浓度在LH(和FSH)激增前一天升至峰值。相比之下,闭经的甲状腺毒症患者雌激素峰值出现但未伴随LH(和FSH)峰值,提示正反馈机制失效。仍有月经的甲状腺毒症患者血浆孕酮水平和模式与甲状腺功能正常的对照相似。然而,闭经的甲状腺毒症患者未检测到显著的循环血浆孕酮。甲状腺功能恢复正常和月经恢复正常后,所有这些激素(促性腺激素、雌激素和孕酮)的水平和模式均恢复正常。

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