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[高雄激素血症与妊娠]

[Hyperandrogenism and pregnancy].

作者信息

Thorin-Savouré A, Kuhn J M

机构信息

Service d'endocrinologie et maladies métaboliques, CHU de Rouen, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France.

出版信息

Ann Endocrinol (Paris). 2002 Oct;63(5):443-51.

Abstract

Normal pregnancy is associated with high circulating levels of total testosterone explained by an increment of the synthesis of testosterone-estradiol-binding globulin (TeBG), and an increase in plasma free-testosterone and androstenedione levels. Protection mechanisms against maternal and fetal virilization conterbalance this biological hyperandrogenism. However, these mechanisms of protection may be overtaken leading to a maternal virilization during pregnancy. Acne, temporal balding, clitoromegaly and hirsutism could be observed. The most important point is to evaluate the risk of virilization of a female fetus. Earlier the hyperandrogenism occurs during pregnancy, higher is the risk of fetal virilization. The first step consists to identify a gestational exposition to androgen, the second to find an organic etiology. The most common etiologies include ovarian luteomas and theca-lutein-cysts. Others ovarian diseases (arrhenoblastomas, Krukenberg tumors and polycystic ovary syndrome) and adrenal causes are much more rare. Unfortunately, there is no treatment available during pregnancy.

摘要

正常妊娠与循环中总睾酮水平升高有关,这是由睾酮 - 雌二醇结合球蛋白(TeBG)合成增加以及血浆游离睾酮和雄烯二酮水平升高所致。针对母体和胎儿男性化的保护机制可抵消这种生理性高雄激素血症。然而,这些保护机制可能会失效,导致孕期母体男性化。可能会观察到痤疮、颞部脱发、阴蒂肥大和多毛症。最重要的是评估女性胎儿男性化的风险。孕期高雄激素血症出现得越早,胎儿男性化的风险就越高。第一步是确定孕期雄激素暴露情况,第二步是找出器质性病因。最常见的病因包括卵巢黄体瘤和卵泡膜黄素囊肿。其他卵巢疾病(睾丸母细胞瘤、克鲁肯伯格瘤和多囊卵巢综合征)以及肾上腺病因则更为罕见。不幸的是,孕期没有可用的治疗方法。

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