Szabó E, Annus J, Zalányi S, Falkay G
Department of Obstetrics and Gynecology, University Medical School, Szeged, Hungary.
Funct Neurol. 1987 Jul-Sep;2(3):315-21.
Of 30 amenorrhoeic women athletes, 28 were considered to have hypothalamic amenorrhoea according to their low gonadotropin, estradiol (E2) and normal testosterone and prolactin (PRL) values. Gonadotropin-releasing hormone (LH-RH 100 micrograms i.v.) and naloxone (4 mg i.v. bolus followed by 2.8 mg/h infusion) tests were administered consecutively. Fifteen subjects reacted to the naloxone test with at least a fivefold increase in LH values; these values were consistently above those of the LH-RH test. The other 13 women reacted similarly to the releasing hormone but not to naloxone. While there were no differences between basal LH values in the two groups, E2 levels tended to be lower in non-responders, but since 1/3 of the values fell below the threshold of sensitivity of the E2 assay, no significance could be calculated. The obvious difference among the subjects could be E2 -mediated, the non-responders representing a deeper level of hypothalamic amenorrhoea. The naloxone test seems to be useful for differentiating between different forms of this condition.
在30名闭经的女运动员中，根据其低促性腺激素、雌二醇（E2）以及正常的睾酮和催乳素（PRL）值，有28名被认为患有下丘脑性闭经。连续进行促性腺激素释放激素（静脉注射100微克促黄体生成素释放激素）和纳洛酮（静脉注射4毫克推注，随后以2.8毫克/小时输注）试验。15名受试者对纳洛酮试验有反应，促黄体生成素值至少增加了五倍；这些值始终高于促黄体生成素释放激素试验的值。其他13名女性对释放激素的反应相似，但对纳洛酮无反应。虽然两组的基础促黄体生成素值没有差异，但无反应者的E2水平往往较低，但由于三分之一的值低于E2检测的灵敏度阈值，因此无法计算出显著性。受试者之间的明显差异可能是由E2介导的，无反应者代表下丘脑性闭经的更深层次。纳洛酮试验似乎有助于区分这种情况的不同形式。
