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[长期应用促性腺激素释放激素(LH-RH)激动剂进行药物去势的前列腺癌患者的睾丸内分泌功能]

[Testicular endocrine function in patients with prostatic cancer receiving medical castration by long-term administration of LH-RH agonists].

作者信息

Isurugi K, Kondo Y, Hirasawa K, Oyamatsu T, Honma Y

出版信息

Nihon Hinyokika Gakkai Zasshi. 1989 Oct;80(10):1466-73. doi: 10.5980/jpnjurol1989.80.1466.

Abstract

Six patients with advanced prostatic cancer who had been treated by long-term administration of LH-RH agonistic preparations (Buserelin or Leupron) were tested for their pituitary-testicular endocrine functions. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2) and dihydrotestosterone (DHT) were measured consecutively. In all medically castrated patients, serum levels of LH, FSH, T, DHT and E2 were suppressed and particularly serum T levels were below the castration level of 1.0 ng/ml. On the other hand, serum PRL levels were unchanged after the long-term treatment with the agonists. Serum LH and FSH levels failed to respond to LH-RH stimulation after the treatment, whereas serum T responded to stimulation by human chorionic gonadotropin (hCG) to various degrees. It was remarkable that, in 4 out of 6 medically castrated patients treated up to more than 3 years, serum T response levels above 1.0 ng/ml were noted. It is suggested that testicular endocrine function to secrete T and DHT in patients under treatment with long-term LH-RH agonist administration are still preserved in response to hCG stimulation.

摘要

对6例长期接受促性腺激素释放激素(LH-RH)激动剂制剂(布舍瑞林或亮丙瑞林)治疗的晚期前列腺癌患者的垂体-睾丸内分泌功能进行了检测。连续测定血清促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)、催乳素(PRL)、雌二醇(E2)和双氢睾酮(DHT)水平。在所有药物去势的患者中,血清LH、FSH、T、DHT和E2水平均受到抑制,尤其是血清T水平低于1.0 ng/ml的去势水平。另一方面,长期使用激动剂治疗后血清PRL水平未发生变化。治疗后血清LH和FSH水平对LH-RH刺激无反应,而血清T对人绒毛膜促性腺激素(hCG)刺激有不同程度的反应。值得注意的是,在6例接受治疗长达3年以上的药物去势患者中,有4例血清T反应水平超过1.0 ng/ml。提示长期接受LH-RH激动剂治疗的患者,其睾丸分泌T和DHT的内分泌功能在hCG刺激下仍得以保留。

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