Saha M-T, Saha H H T, Niskanen L K, Salmela K T, Pasternack A I
University of Tampere, Medical School, Tampere, Finland.
Nephron. 2002;92(3):735-7. doi: 10.1159/000064079.
Chronic renal failure is commonly associated with disturbances in hypothalamic-pituitary-gonadal function.
The gonadotrophins, prolactin and estradiol or testosterone levels were measured immediately before renal transplantation, at discharge from the transplantation unit (19 +/- 8 days after Tx) and 6 months after transplantation in 21 patients, 7 females and 14 males, age range 21-60 years.
The mean prolactin level was high during uremia and decreased rapidly after transplantation, from 441 to 167 mU/l in males and from 1,057 to 521 mU/l in females. Hypergonadotrophism was seen in most uremic patients, with the mean LH and FSH levels of 14.2 and 6.0 U/l in males and 14.7 and 4.0 U/l in females, respectively. A temporary change to hypogonadotrophic hypogonadism took place 2-3 weeks after transplantation and was followed by normalization of the hypothalamic-gonadal function. The levels of circulating sex steroids were suppressed when the patients were discharged from the transplantation unit but returned to the normal range at 6 months.
We conclude that renal transplantation corrects the hyperprolactinemia induced by uremia and is followed by rapid onset of restoration of the hypothalamic-pituitary-gonadal axis.
慢性肾衰竭常伴有下丘脑 - 垂体 - 性腺功能紊乱。
对21例患者(7例女性,14例男性,年龄范围21 - 60岁)在肾移植前、移植病房出院时(移植后19±8天)和移植后6个月时立即测定促性腺激素、催乳素以及雌二醇或睾酮水平。
男性患者在尿毒症期催乳素平均水平较高,移植后迅速下降,从441降至167 mU/l;女性患者从1057降至521 mU/l。大多数尿毒症患者存在高促性腺激素血症,男性患者促黄体生成素(LH)和促卵泡生成素(FSH)平均水平分别为14.2和6.0 U/l,女性患者分别为14.7和4.0 U/l。移植后2 - 3周出现暂时性的低促性腺激素性性腺功能减退,随后下丘脑 - 性腺功能恢复正常。移植病房出院时患者循环性激素水平受到抑制,但在6个月时恢复到正常范围。
我们得出结论,肾移植可纠正尿毒症所致的高催乳素血症,并随后迅速恢复下丘脑 - 垂体 - 性腺轴。