Genazzani A D, Petraglia F, Fabbri G, Monzani A, Montanini V, Genazzani A R
Department of Obstetrics and Gynecology, University of Modena, Via, Italy.
Fertil Steril. 1990 Aug;54(2):222-6. doi: 10.1016/s0015-0282(16)53693-0.
The lack of plasma luteinizing hormone (LH) pulsatile pattern or episodic LH secretory bursts during night have been demonstrated in hypothalamic amenorrhea. The availability of both sensitive and specific immunofluorimetric assay and algorithm for pulse detection enabled us to reanalyze the question of whether or not patients with hypothalamic amenorrhea secrete LH in a pulsatile fashion. Seven women with secondary amenorrhea associated with weight loss and four normally cycling women were studied, sampling every 5 minutes for 8 hours. Control subjects were studied during four different phases of the menstrual cycle. In all amenorrheic patients, a frequent LH pulsatile secretion, with pulses of low amplitude, was found (10.7 +/- 1.4 peaks/8 h; mean +/- SEM). The pulse frequency was significantly higher (P less than 0.05) than any phases of the control group (early follicular: 7 +/- 0.4 peaks/8 h; late follicular: 6.8 +/- 0.6 peaks/8 h; early luteal: 4.3 +/- 0.4 peaks/8 h; late luteal: 7 +/- 0.3 peaks/8 h). The LH pulsatile release in amenorrheic patients showed a mean pulse duration and amplitude shorter than in any phase of the menstrual cycle of the controls. In conclusion, in weight-loss-related-amenorrhea, the major change was not the absence of the LH pulsatile release but its increased frequency with reduced pulse amplitude.
在下丘脑性闭经患者中，已证实夜间缺乏血浆促黄体生成素（LH）的脉冲式分泌模式或LH分泌突发脉冲。灵敏且特异的免疫荧光测定法及脉冲检测算法的出现，使我们能够重新分析下丘脑性闭经患者是否以脉冲方式分泌LH这一问题。研究了7名与体重减轻相关的继发性闭经女性和4名月经周期正常的女性，每5分钟采样一次，共8小时。对对照受试者在月经周期的四个不同阶段进行了研究。在所有闭经患者中，均发现LH频繁脉冲式分泌，但脉冲幅度较低（10.7±1.4个峰值/8小时；均值±标准误）。其脉冲频率显著高于对照组的任何阶段（卵泡早期：7±0.4个峰值/8小时；卵泡晚期：6.8±0.6个峰值/8小时；黄体早期：4.3±0.4个峰值/8小时；黄体晚期：7±0.3个峰值/8小时）（P<0.05）。闭经患者中LH的脉冲式释放显示，其平均脉冲持续时间和幅度均短于对照组月经周期的任何阶段。总之，在与体重减轻相关的闭经中，主要变化并非LH脉冲式释放的缺失，而是其频率增加且脉冲幅度降低。
