对于大多数接受传统治疗的无功能垂体腺瘤男性患者，克罗米芬无法恢复性腺功能减退。
Clomiphene fails to revert hypogonadism in most male patients with conventionally treated nonfunctioning pituitary adenomas.
作者信息
Ribeiro Rogerio Silicani, Abucham Julio
机构信息
Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2011 Jun;55(4):266-71. doi: 10.1590/s0004-27302011000400005.
OBJECTIVE
To evaluate the effect of clomiphene in men with hypogonadism and conventionally treated nonfunctioning pituitary adenomas (NFPA).
PATIENTS AND METHODS
Open label, single-arm, prospective trial. Nine hypogonadal men (testosterone < 300 ng/dL and low/normal LH) with previously treated NFPA. Clomiphene (50 mg/day orally) for 12 weeks. Testosterone, estradiol, LH, FSH, prolactin and erectile function were evaluated before and after 10 days, 4, 8 and 12 weeks of clomiphene treatment.
RESULTS
After clomiphene treatment, testosterone and erectile function improved in only one patient. In the remaining eight patients, testosterone levels decreased whereas LH, FSH, and estradiol remained unchanged. Insulin sensitivity increased in unresponsive patients.
CONCLUSIONS
Compared with hypogonadal men with prolactinomas under dopaminergic therapy, clomiphene treatment failed to restore normal testosterone levels in most patients with conventionally treated NFPA.
目的
评估克罗米芬对性腺功能减退且接受传统治疗的无功能垂体腺瘤（NFPA）男性患者的疗效。
患者与方法
开放标签、单臂、前瞻性试验。9名性腺功能减退男性（睾酮<300 ng/dL且促黄体生成素水平低/正常），此前已接受NFPA治疗。口服克罗米芬（50 mg/天），持续12周。在克罗米芬治疗10天、4周、8周和12周前后，评估睾酮、雌二醇、促黄体生成素、促卵泡生成素、催乳素和勃起功能。
结果
克罗米芬治疗后，仅1例患者的睾酮和勃起功能有所改善。其余8例患者中，睾酮水平下降，而促黄体生成素、促卵泡生成素和雌二醇水平保持不变。无反应患者的胰岛素敏感性增加。
结论
与接受多巴胺能治疗的泌乳素瘤性腺功能减退男性相比，克罗米芬治疗未能使大多数接受传统治疗的NFPA患者恢复正常睾酮水平。
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