Davajan V, Kletzky O, Vermesh M, Anderson D J
Department of Obstetrics and Gynecology, Los Angeles County-University of Southern California School of Medicine.
Am J Obstet Gynecol. 1991 Jun;164(6 Pt 1):1666-70; discussion 1670-2. doi: 10.1016/0002-9378(91)91453-4.
A group of 46 patients with secondary amenorrhea without galactorrhea or hyperprolactinemia were studied retrospectively after being clinically categorized into four groups with the use of progesterone-induced uterine bleeding and measurement of serum gonadotropins and prolactin levels. The ability to have regular spontaneous menstrual cycles and to conceive was assessed after a follow-up period of 10 years. Patients who had been classified as having hypothalamic pituitary "failure" (hypoestrogenic amenorrhea) with low levels of circulating estradiol had a greater rate of recovery of spontaneous ovulation and menses when compared with patients who had been classified as having only hypothalamic pituitary dysfunction (euestrogenic amenorrhea). The patients with diagnosis of hyperandrogenic chronic anovulation or polycystic ovary syndrome generally required clomiphene citrate for induction of ovulation and almost all the patients with premature ovarian failure (hypergonadotropic amenorrhea) remained estrogen-deficient and unable to ovulate. Hyperprolactinemia or an identifiable pituitary adenoma has not developed in any of the patients to date.
一组46例无溢乳或高催乳素血症的继发性闭经患者，在临床上通过孕激素诱导子宫出血以及检测血清促性腺激素和催乳素水平分为四组后进行回顾性研究。经过10年的随访期，评估其出现规律自然月经周期和受孕的能力。与被归类为仅患有下丘脑 - 垂体功能障碍（雌激素正常性闭经）的患者相比，被归类为患有下丘脑 - 垂体“功能衰竭”（低雌激素性闭经）且循环雌二醇水平低的患者，自发排卵和月经恢复率更高。诊断为高雄激素性慢性无排卵或多囊卵巢综合征的患者通常需要使用枸橼酸氯米芬诱导排卵，而几乎所有卵巢早衰（高促性腺激素性闭经）患者仍缺乏雌激素且无法排卵。迄今为止，所有患者均未出现高催乳素血症或可识别的垂体腺瘤。
