Kandeel F R, Butt W R, Rudd B T, Lynch S S, London D R, Edwards R L
Clin Endocrinol (Oxf). 1979 Jun;10(6):619-35. doi: 10.1111/j.1365-2265.1979.tb02121.x.
An LHRH test was performed before and at both 44 and 92 h after the administration of 2.5 mg oestradiol benzoate in eleven patients with hyperprolactinaemia, eight with idiopathic secondary amenorrhoea and seven with oligomenorrhoea. The basal serum hormone concentrations and the responses to LHRH were compared with the same tests performed on ten normal subjects during the early follicular phase of their menstrual cycles (days 4--6). Mean basal concentrations of oestradiol in each group of patients and oestrone in those with hyperprolactinaemia were significantly lower than in the normal subjects. The mean concentration of prolactin in women with secondary amenorrhoea remained lower than in the normal women throught the tests (P less than 0.05). The LH and FSH responses to LHRH before oestrogen in patients with hyperprolactinaemia and of FSH in those with secondary amenorrhoea, were greater than in the normal subjects (P less than 0.001). After oestrogen treatment the responses were similar in all groups except in those with oligomenorrhoea where LH and FSH responses at 44 h (P less than 0.05 and P less than 0.01 respectively) and LH responses at 92 h (P less than 0.01) were lower than in normal controls. The responses at 92 h in all groups were greater than at 44 h (amplification) but the amplification at 92 h and at 44 h compared to the pre-treatment responses, tended to be lower in each group of patients compared to the normal controls. In the hyperprolactinaemic group of patients there was a negative correlation between the basal prolactin concentration and the gonadotrophin amplifications at 92 h (P less than 0.01), and a positive correlation between the basal oestrone levels and the amplifications at 92 h (P less than 0.01). The results of the oestrogen amplification test in eleven of the non-hyperprolactinaemic anovular patients were compared with the ovulatory response to 100 mg clomiphene given for 5 days. Six showed a normal oestrogen amplification and they all ovulated. Two patients failed to show greater amplification at 92 than at 44 h and required human chorionic gonadotrophin (HCG) as well as clomiphene to ovulate. The other three showed a diminished LH amplification at 92 h; they required 200 mg clomiphene and showed a prolonged follicular phase. The responses of the hyperprolactinaemic patients to clomiphene were poor and there was a negative correlation between prolactin concentration and oestrogen production (P less than 0.01). All ten hyperprolactinaemic patients treated with bromocriptine ovulated and eight conceived. The oestrogen amplification test appears to have some value in predicting the subsequent response to clomiphene in non-hyperprolactinaemic anovular women.
对11例高泌乳素血症患者、8例特发性继发性闭经患者和7例月经过少患者，在给予2.5mg苯甲酸雌二醇之前以及给药后44小时和92小时进行了促性腺激素释放激素（LHRH）试验。将基础血清激素浓度和对LHRH的反应与10名正常受试者在月经周期卵泡早期（第4 - 6天）进行的相同试验进行比较。每组患者中雌二醇的平均基础浓度以及高泌乳素血症患者中雌酮的平均基础浓度均显著低于正常受试者。继发性闭经女性的泌乳素平均浓度在整个试验过程中均低于正常女性（P < 0.05）。高泌乳素血症患者在雌激素给药前对LHRH的促黄体生成素（LH）和促卵泡生成素（FSH）反应以及继发性闭经患者对FSH的反应均大于正常受试者（P < 0.001）。雌激素治疗后，除月经过少患者外，所有组的反应相似，月经过少患者在44小时时LH和FSH反应（分别为P < 0.05和P < 0.01）以及92小时时LH反应（P < 0.01）低于正常对照。所有组在92小时时的反应均大于44小时时的反应（放大），但与治疗前反应相比，92小时和44小时时的放大倍数在每组患者中均低于正常对照。在高泌乳素血症患者组中，基础泌乳素浓度与92小时时促性腺激素放大倍数之间呈负相关（P < 0.01），基础雌酮水平与92小时时放大倍数之间呈正相关（P < 0.01）。将11例非高泌乳素血症无排卵患者的雌激素放大试验结果与给予5天100mg克罗米芬后的排卵反应进行了比较。6例显示雌激素放大正常且均排卵。2例患者在92小时时未显示出比44小时时更大的放大倍数，需要人绒毛膜促性腺激素（HCG）以及克罗米芬才能排卵。另外3例在92小时时LH放大减弱；她们需要200mg克罗米芬且卵泡期延长。高泌乳素血症患者对克罗米芬的反应较差，泌乳素浓度与雌激素产生之间呈负相关（P < 0.01）。所有10例接受溴隐亭治疗的高泌乳素血症患者均排卵，8例受孕。雌激素放大试验似乎在预测非高泌乳素血症无排卵女性随后对克罗米芬的反应方面具有一定价值。
