烧伤男性患者性腺功能减退的发病机制。
Mechanisms leading to hypogonadism in men with burns injuries.
作者信息
Semple C G, Robertson W R, Mitchell R, Gordon D, Gray C E, Beastall G H, Reid W H
机构信息
Medical Unit B, Southern General Hospital, Glasgow.
出版信息
Br Med J (Clin Res Ed). 1987 Aug 15;295(6595):403-7. doi: 10.1136/bmj.295.6595.403.
A profound and persistent depression of serum testosterone concentrations was found in 19 men with burns injuries. This could not be explained by changes in sex hormone binding globulin capacity, hyperprolactinaemia, classical primary testicular failure, or a hypogonadotrophic state. Pulsatile release of luteinising hormone was found in control subjects but was absent or diminished in burnt patients with low serum testosterone concentrations. In addition, these patients showed reduced biological activity of luteinising hormone as measured by bioassay even though normal concentrations of luteinising hormone were detected by radioimmunoassay. The temporary hypogonadism after burns injury and possibly in other clinical states may be related to hypothalamic dysfunction, which leads to abnormal generation of luteinising hormone releasing hormone and non-pulsatile secretion of luteinising hormone of reduced biological activity.
在19名烧伤患者中发现血清睾酮浓度出现了严重且持续的降低。这无法通过性激素结合球蛋白能力的变化、高催乳素血症、典型的原发性睾丸功能衰竭或性腺功能减退状态来解释。在对照受试者中发现了促黄体生成素的脉冲式释放，但在血清睾酮浓度较低的烧伤患者中，这种释放不存在或减弱。此外，尽管通过放射免疫测定法检测到促黄体生成素浓度正常，但通过生物测定法测量发现这些患者的促黄体生成素生物活性降低。烧伤后以及可能在其他临床状态下出现的暂时性性腺功能减退可能与下丘脑功能障碍有关，下丘脑功能障碍会导致促黄体生成素释放激素生成异常以及生物活性降低的促黄体生成素非脉冲式分泌。
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