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短期给予雌三醇可调节功能性下丘脑性闭经(FHA)患者的下丘脑 - 垂体功能。

Short-term estriol administration modulates hypothalamo-pituitary function in patients with functional hypothalamic amenorrhea (FHA).

作者信息

Genazzani Alessandro D, Podfigurna-Stopa Agnieszka, Czyzyk Adam, Katulski Krzysztof, Prati Alessia, Despini Giulia, Angioni Stefano, Simoncini Tommaso, Meczekalski Blazej

机构信息

a Department of Obstetrics and Gynecology , University of Modena and Reggio Emilia , Modena , Italy .

b Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland .

出版信息

Gynecol Endocrinol. 2016;32(3):253-7. doi: 10.3109/09513590.2015.1118452. Epub 2015 Dec 3.

Abstract

OBJECTIVE

To evaluate the influence of short-term estriol administration (10 d) on the hypothalamus-pituitary function and gonadotropins secretion in patients affected by functional hypothalamic amenorrhea (FHA).

STUDY DESIGN

Controlled clinical study on patients with FHA (n = 12) in a clinical research environment.

INTERVENTION(S): Hormonal determinations and gonadotropin (luteinizing hormone [LH] and FSH) response to a gonadotropin-releasing hormone (GnRH) bolus (10 μg) at baseline condition and after 10 d of therapy with 2 mg/d of estriol per os.

MAIN OUTCOME MEASURE(S): Measurements of plasma LH, FSH, prolactin, estradiol, androstenedione, 17α-hydroxyprogesterone, insulin, cortisol, thyroid-stimulating hormone, free triiodothyronine, and free thyroxine.

RESULT(S): After treatment, the FHA patients showed a statistically significant increase of both LH and FSH plasma levels and the significant increase of their responses to the GnRH bolus.

CONCLUSION(S): Estriol short-term therapy modulates within 10 d of administration the neuroendocrine control of the hypothalamus-pituitary unit and induces the recovery of both gonadotropins synthesis and secretion in hypogonadotropic patients with FHA.

摘要

目的

评估短期服用雌三醇(10天)对功能性下丘脑性闭经(FHA)患者下丘脑-垂体功能及促性腺激素分泌的影响。

研究设计

在临床研究环境中对FHA患者(n = 12)进行对照临床研究。

干预措施

在基线状态及口服2mg/d雌三醇治疗10天后,测定激素水平及促性腺激素(促黄体生成素[LH]和促卵泡生成素[FSH])对促性腺激素释放激素(GnRH)推注(10μg)的反应。

主要观察指标

测定血浆LH、FSH、催乳素、雌二醇、雄烯二酮、17α-羟孕酮、胰岛素、皮质醇、促甲状腺激素、游离三碘甲状腺原氨酸和游离甲状腺素。

结果

治疗后,FHA患者血浆LH和FSH水平均有统计学意义的显著升高,且对GnRH推注的反应也显著增加。

结论

雌三醇短期治疗在给药10天内可调节下丘脑-垂体单位的神经内分泌控制,并促使FHA性腺功能减退患者的促性腺激素合成及分泌恢复。

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