Armeanu M C, Lambalk C B, Berkhout G M, Schoemaker J
Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
Gynecol Endocrinol. 1992 Mar;6(1):3-12. doi: 10.3109/09513599209081000.
Although endogenous opioids seem to play an important role in the inhibition of luteinizing hormone releasing hormone (LHRH) secretion in women with hypothalamic amenorrhea, opioid antagonism does not always cause an increase of pituitary luteinizing hormone (LH) secretion. The effect of the long-acting oral opiate antagonist naltrexone on pulsatile LH secretion was studied in eight women with weight loss and exercise-related hypothalamic amenorrhea. LH pulse studies and LHRH tests were performed in basal conditions and after 4 days of naltrexone treatment, 50 mg q.d. Naltrexone caused a slight, but significant increase of LH pulse frequency. Six weeks later, a second experiment was performed. The response to naltrexone was studied after enhancement of the pituitary sensitivity. Patients were pretreated with pulsatile LHRH during 4 days, followed by naltrexone 50 mg q.d. during 4 days. An increased LH response to LHRH, but no response to naltrexone, were seen after discontinuation of pulsatile LHRH. It is concluded that the limited pituitary response to opioid antagonism, observed in weight loss-related forms of hypothalamic amenorrhea, is not caused by pituitary insensitivity to LHRH.
虽然内源性阿片类物质似乎在下丘脑性闭经女性的促黄体生成激素释放激素（LHRH）分泌抑制中起重要作用，但阿片类拮抗剂并不总是能导致垂体促黄体生成激素（LH）分泌增加。对8名因体重减轻和运动相关的下丘脑性闭经女性，研究了长效口服阿片拮抗剂纳曲酮对LH脉冲式分泌的影响。在基础状态下以及纳曲酮治疗4天（每日50毫克）后，进行了LH脉冲研究和LHRH试验。纳曲酮使LH脉冲频率略有但显著增加。六周后，进行了第二项实验。在增强垂体敏感性后，研究了对纳曲酮的反应。患者先接受4天的脉冲式LHRH预处理，随后4天每日给予50毫克纳曲酮。在停止脉冲式LHRH后，观察到对LHRH的LH反应增加，但对纳曲酮无反应。得出的结论是，在与体重减轻相关的下丘脑性闭经形式中观察到的垂体对阿片类拮抗剂的有限反应，并非由垂体对LHRH不敏感所致。
