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[多毛症诊断的各个方面]

[Various aspects of the diagnosis of hirsutism].

作者信息

Farta L Ia, Kushlinskiĭ N E

出版信息

Probl Endokrinol (Mosk). 1986 Nov-Dec;32(6):25-30.

PMID:2949323
Abstract

A study was made of total testosterone, estradiol, androstenedione, dehydroepiandrosterone-sulphate, progesterone, testosterone and estradiol binding by transport proteins (sex steroid binding by globulin and albumin) in the blood plasma, androgen cytoplasmic receptors in pubic skin biopsy in 35 patients with hirsutism of various degree of expression and disturbance of menstrual function. An increase in low active androgens (androstenedione and dehydroepiandrosterone-sulphate in most women) interpreted clinically as idiopathic form of hirsutism, was noted. Low levels of androgens in the presence of the lowest indices of estradiol, progesterone and sex steroid binding globulin and the highest results of free and albumin bound testosterone fraction as well as the index of free androgens in patients with Stage III hirsutism were found against a background of irregular menses which could promote more pronounced virilization in these women. A degree of expression of hirsutism showed correlation with the results of determination of the free androgen index reflecting androgen biological activity. The authors revealed reverse correlation of the concentration of total testosterone, its free fraction and the number of common sites of the binding of dehydrotestosterone with receptor proteins as well as the frequency of detection of androgen free receptors in the pubic skin cytosol of patients with a various degree of hirsutism.

摘要

对35例不同程度多毛症且月经功能紊乱的患者进行了研究,检测其血浆中总睾酮、雌二醇、雄烯二酮、硫酸脱氢表雄酮、孕酮,以及运输蛋白结合的睾酮和雌二醇(性类固醇与球蛋白和白蛋白的结合),并对其耻骨皮肤活检中的雄激素细胞质受体进行检测。结果发现,大多数女性中低活性雄激素(雄烯二酮和硫酸脱氢表雄酮)增加,临床上将其解释为特发性多毛症。在月经不规律的背景下,Ⅲ期多毛症患者的雌二醇、孕酮和性类固醇结合球蛋白指标最低,游离及白蛋白结合睾酮分数以及游离雄激素指数结果最高,而雄激素水平较低,这可能会促使这些女性出现更明显的男性化。多毛症的表达程度与反映雄激素生物活性的游离雄激素指数测定结果相关。作者发现,不同程度多毛症患者的血浆总睾酮浓度、其游离分数、脱氢睾酮与受体蛋白结合的共同位点数量,以及耻骨皮肤细胞质中雄激素游离受体的检测频率之间呈负相关。

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