Rudolf K, Rudolf H, Rüting M, Falkenhagen D
Klinik für Gynäkologie und Geburtshilfe, Bereiches Medizin der Wilhelm-Pieck-Universität Rostock.
Z Gesamte Inn Med. 1988 Oct 1;43(19):542-4.
In 11 female patients with chronic uraemia at the age of 20 to 47 years (average age: 33.1 years) the behaviour of basal and stimulated serum levels of prolactin (PRL), growth hormone (HGH) and gonadotropins (LH, FSH) was investigated. For stimulation of the hormone secretion a sequential test with arginine hydrochloride, gonadotropin releasing hormone (GnRH) and thyrotropin releasing hormone (TRH) was used. In 2 women the investigations were repeated after kidney transplantation. The determination of LH, FSH, PRL and HGH was performed radioimmunologically. The investigations show that in women with chronic uraemia the basal LH-levels in general lie clearly above of those ones of women with biphasic cycles, whereas the FSH-levels are not increased. The LH-response after administration of 25 micrograms GnRH is adequate in 6 women and is absent in 5 women. After kidney transplantation a clear reduction of the basal LH-levels in comparison to the preliminary values is to be established. The increased basal LH-levels are causally made responsible for the disturbances of the menstrual cycle in women with chronic uraemia. For PRL hyper- and normoprolactinaemic as well as hypoprolactinaemic basal levels are found. A connection between the height of the PRL and creatinine levels cannot be proved. Apart from a adequate PRL response to the stimulation with TRH in the individual case this response is inadequate or is absent. The basal HGH-levels are in the area of reference. In all women HGH can adequately be stimulated, whereby the case in question is presumably a so-called paradoxical TRH-effect.
对11名年龄在20至47岁(平均年龄:33.1岁)的慢性尿毒症女性患者,研究了基础及刺激状态下血清催乳素(PRL)、生长激素(HGH)和促性腺激素(LH、FSH)的变化情况。采用盐酸精氨酸、促性腺激素释放激素(GnRH)和促甲状腺激素释放激素(TRH)的序贯试验来刺激激素分泌。2名女性在肾移植后重复进行了检查。采用放射免疫法测定LH、FSH、PRL和HGH。研究表明,慢性尿毒症女性的基础LH水平总体明显高于月经周期正常的女性,而FSH水平未升高。给予25微克GnRH后,6名女性的LH反应正常,5名女性无反应。肾移植后,与初始值相比,基础LH水平明显降低。基础LH水平升高是慢性尿毒症女性月经周期紊乱的原因。PRL水平有高泌乳素血症、正常泌乳素血症及低泌乳素血症的基础值。未证实PRL水平与肌酐水平之间存在关联。除个别病例对TRH刺激有适当的PRL反应外,这种反应不充分或无反应。基础HGH水平在参考范围内。所有女性的HGH均可被充分刺激,据此推测该病例可能是所谓的TRH矛盾效应。