Komarov E K
Akush Ginekol (Mosk). 1991 Dec(12):41-4.
ACTH, prolactin, hydrocortisone, 17 OH-progesterone, androstenedione, dehydroepiandrosterone C, and testosterone were measured in the blood of 36 androgenic women and 8 healthy ones before and after adrenal stimulation. The findings evidence that various mechanisms are responsible for the development of androgynism of an adrenal origin. In patients with congenital virilizing adrenocortical hyperplasia and 21 hydroxylase deficiency excessive androgen production results mainly from activation of delta-4 route of androgen synthesis; in patients with adrenal androgynism and insufficiency of enzymic systems of steroidogenesis the androgen production is explained by functional hyperactivity of the bundle and retinal zones of the adrenal cortex and hyperreactivity to stimulating factors. Hyperproduction of androgens is related to ovarian hyperproduction of not only androstenedione and testosterone, but, in some patients, of dehydroepiandrosterone C as well. Elevated basal blood level of this enzyme cannot be regarded as a sufficiently reliable criterion in the differential diagnosis of the adrenal or ovarian origin of androgynism.
在36名雄激素过多的女性和8名健康女性的血液中，检测了促肾上腺皮质激素（ACTH）、催乳素、氢化可的松、17-羟孕酮、雄烯二酮、脱氢表雄酮C和睾酮在肾上腺刺激前后的水平。研究结果表明，肾上腺源性雌雄同体的发生有多种机制。在先天性肾上腺皮质增生伴21-羟化酶缺乏的患者中，雄激素过度产生主要源于雄激素合成的δ-4途径的激活；在肾上腺雌雄同体和类固醇生成酶系统不足的患者中，雄激素的产生是由肾上腺皮质束状带和网状带的功能性亢进以及对刺激因子的高反应性所解释的。雄激素的过度产生不仅与卵巢中雄烯二酮和睾酮的过度产生有关，而且在一些患者中还与脱氢表雄酮C的过度产生有关。这种酶的基础血水平升高不能被视为在鉴别诊断雌雄同体的肾上腺或卵巢起源时足够可靠的标准。
