Taketani Y, Ishikawa H, Kinoshita T, Mizuno M
Nihon Sanka Fujinka Gakkai Zasshi. 1986 Oct;38(10):1697-701.
Plasma levels of androstenedione (A) and dehydroepiandrosterone sulfate (DHAS) were measured in 29 women with PCO in an attempt to classify PCO. A and/or DHAS were elevated in all cases. In cases with DHAS levels below 2,000 ng/ml, the A levels were found to be over 1.4 ng/ml. This group was defined as an ovarian type because the major source of A is the ovary. In contrast, women whose DHAS levels were higher than 2,000 ng/ml were classified as an adrenal type. In both groups, the hormonal features were elevated LH levels and exaggerated LH response to LHRH. The mean A levels were 2.43 +/- 0.31 ng/ml in ovarian type and 2.20 +/- 0.42 ng/ml in adrenal type. The mean DHAS levels for the adrenal type were 3,052 +/- 299 ng/ml, or about 3 times as high as normal values. On the other hand, those for the ovarian type were on the upper borderline of the normal range. In both groups, dexamethasone lowered DHAS levels by about 80% with no discernible effect upon A levels. The successful rate for ovulation-induction by clomiphene was 20% in the ovarian and 33% in the adrenal. Bromocriptine induced ovulation in 8 out of 9 cases of the ovarian type. However, only one of 6 responded to bromocriptine in the adrenal type. Bromocriptine-unresponsive cases of the adrenal type ovulated following treatment with combination of clomiphene and prednisolone. In summary, we attempted to classify PCO into ovarian and adrenal types by analyzing the elevated androgen level. This classification seems to be useful in the treatment of PCO and also provides some insight into the pathogenesis of PCO.
为了对多囊卵巢综合征（PCO）进行分类，对29例PCO女性的血浆雄烯二酮（A）和硫酸脱氢表雄酮（DHAS）水平进行了测定。所有病例中A和/或DHAS均升高。在DHAS水平低于2000 ng/ml的病例中，发现A水平超过1.4 ng/ml。该组被定义为卵巢型，因为A的主要来源是卵巢。相比之下，DHAS水平高于2000 ng/ml的女性被归类为肾上腺型。两组的激素特征均为促黄体生成素（LH）水平升高以及对促性腺激素释放激素（LHRH）的LH反应增强。卵巢型的平均A水平为2.43±0.31 ng/ml，肾上腺型为2.20±0.42 ng/ml。肾上腺型的平均DHAS水平为3052±299 ng/ml，约为正常值的3倍。另一方面，卵巢型的DHAS水平处于正常范围的上限。两组中，地塞米松使DHAS水平降低约80%，而对A水平无明显影响。克罗米芬诱导排卵的成功率在卵巢型中为20%，在肾上腺型中为33%。溴隐亭在9例卵巢型病例中有8例诱导排卵。然而，肾上腺型的6例中只有1例对溴隐亭有反应。肾上腺型中对溴隐亭无反应的病例在克罗米芬和泼尼松龙联合治疗后排卵。总之，我们试图通过分析升高的雄激素水平将PCO分为卵巢型和肾上腺型。这种分类似乎对PCO的治疗有用，也为PCO的发病机制提供了一些见解。
