Odagiri E, Yamanaka Y, Ishiwatari N, Jibiki K, Demura R, Demura H, Suda T, Shizume K
Radioassay Center, Tokyo Women's Medical College, Japan.
Endocrinol Jpn. 1988 Jun;35(3):421-7. doi: 10.1507/endocrj1954.35.421.
Basal levels of sex steroids, and the responses of LH and FSH to LH-RH were studied in twenty-five female patients with Cushing's syndrome (17 Cushing's disease and 8 adrenocortical adenoma). Only two patients had a regular menstrual cycle. Amenorrhea or oligomenorrhea had been of long duration in the other cases except for three postmenopausal patients. In patients with Cushing's disease, basal estradiol was low or below normal in 86%. Progesterone was normal in 83%, but testosterone was high in half of the cases. The response of LH to LH-RH in patients with Cushing's disease was normal in 35%, low in 35% and high in 29% of the cases. FSH response to LH-RH was normal in 23.5%, low in 23.5% and high in 53%. In patients with adrenocortical adenoma, basal of estradiol was low or below normal, but progesterone and testosterone were normal in all cases. The response of LH and FSH to LH-RH in all patients with adrenocortical adenoma was higher than normal. In three postmenopausal women, a higher response of LH and FSH to LH-RH was seen in two cases and suppressed in one case. These data suggest that the main site of suppression of the gonadal axis in patients with adrenocortical adenoma is the gonad rather than the pituitary gland or hypothalamus, though the mechanism of hypogonadism in patients with Cushing's disease is heterogeneous.
对25例库欣综合征女性患者（17例库欣病和8例肾上腺皮质腺瘤）的性类固醇基础水平以及促黄体生成素（LH）和促卵泡生成素（FSH）对促性腺激素释放激素（LH-RH）的反应进行了研究。只有2例患者月经周期规律。除3例绝经后患者外，其他病例闭经或月经过少持续时间较长。在库欣病患者中，86%的患者基础雌二醇水平低或低于正常。83%的患者孕酮正常，但半数病例睾酮水平高。库欣病患者中，LH对LH-RH的反应35%正常，35%降低，29%升高。FSH对LH-RH的反应23.5%正常，23.5%降低，53%升高。在肾上腺皮质腺瘤患者中，基础雌二醇水平低或低于正常，但所有病例孕酮和睾酮均正常。所有肾上腺皮质腺瘤患者LH和FSH对LH-RH的反应均高于正常。在3例绝经后女性中，2例LH和FSH对LH-RH的反应增强，1例受到抑制。这些数据表明，肾上腺皮质腺瘤患者性腺轴抑制的主要部位是性腺而非垂体或下丘脑，尽管库欣病患者性腺功能减退的机制是异质性的。
