Raffi F, Brisseau J M, Planchon B, Rémi J P, Barrier J H, Grolleau J Y
Department of Internal Medicine, Hôtel-Dieu, Nantes, France.
AIDS. 1991 Jun;5(6):729-33. doi: 10.1097/00002030-199106000-00013.
Endocrine function was prospectively evaluated in 98 patients (73 men and 25 women) infected by HIV in various stages of illness: Centers for Disease Control groups II (19), III (20), IVA and IVC2 (27), IVC1 and IVD (32). Testing included baseline and post-stimulation evaluation of gonadal, thyroidal, and adrenal axes. Although adrenal function was within normal values in most cases, with no differences between patient groups, nine out of 98 patients had either a low baseline or post-stimulation serum cortisol, cytomegalovirus adrenalitis being suspected in two cases. Mineralocorticoid response was normal in all individuals. The main abnormalities were sick euthyroid syndrome with low tri-idothyronine and/or thyroxine in 16% of patients and hypotestosteronemia in 29% of men with AIDS. These abnormalities, related to a functional deficiency of the hypothalamic-pituitary axis, were highly correlated with the degree of illness, i.e. weight loss and low CD4+ cell count. It was concluded that endocrine dysfunction in HIV-infected patients is rarely of clinical significance, that it is related more to cachexia and advanced disease than to HIV or opportunistic infections, and that it could serve as a prognostic marker.
对98例处于不同疾病阶段的HIV感染者（73例男性和25例女性）的内分泌功能进行了前瞻性评估：疾病控制中心II组（19例）、III组（20例）、IVA和IVC2组（27例）、IVC1和IVD组（32例）。检测包括性腺、甲状腺和肾上腺轴的基线及刺激后评估。虽然大多数情况下肾上腺功能在正常范围内，患者组之间无差异，但98例患者中有9例基线或刺激后血清皮质醇水平较低，其中2例怀疑患有巨细胞病毒性肾上腺炎。所有个体的盐皮质激素反应均正常。主要异常情况为16%的患者出现低三碘甲状腺原氨酸和/或甲状腺素的病态正常甲状腺综合征，以及29%的艾滋病男性患者出现睾酮水平低下。这些与下丘脑 - 垂体轴功能缺陷相关的异常情况与疾病程度高度相关，即体重减轻和CD4 +细胞计数低。得出的结论是，HIV感染患者的内分泌功能障碍很少具有临床意义，它更多与恶病质和晚期疾病有关，而非与HIV或机会性感染有关，并且它可作为一种预后标志物。
