Moltz L, Sörensen R, Römmler A, Schwartz U, Hammerstein J
Geburtshilfe Frauenheilkd. 1985 Feb;45(2):107-14. doi: 10.1055/s-2008-1036216.
This study compares the clinical, biochemical and laparoscopic findings in androgenized patients with (n = 33) and without (n = 17) polycystic ovaries (PCO). It included selective ovarian-adrenal vein catheterisation with measurement of testosterone, dihydrotestosterone, delta 4-androstendione, dehydroepiandrosterone and its sulfate, 17 alpha-hydroxyprogesterone and cortisol in peripheral and glandular venous samples; determination of free testosterone, oestradiol, oestron, LH, FSH and prolactin in peripheral blood; GnRH and TRH double stimulation, as well as dexamethasone suppression tests. There was no correlation between the morphological, clinical, and endocrine changes. A PCO-specific hormonal pattern was not identifiable. Based on catheterisation data, combined ovarian-adrenal androgen hypersecretion was found in 46% of PCO cases; purely ovarian (21%) or adrenal (12%) overproduction were not as frequent. The dynamic function tests proved to be non-specific; e.g., dexamethasone suppressed not only adrenal, but also ovarian androgen output. It is concluded from these data that PCO are not a nosologic entity, but rather a non-obligatory sign of hyperandrogenism. Laparoscopy is, therefore, without clinical relevance in these patients with non-neoplastic hyperandrogenaemia.
本研究比较了患有(n = 33)和未患有(n = 17)多囊卵巢(PCO)的雄激素化患者的临床、生化和腹腔镜检查结果。研究包括选择性卵巢 - 肾上腺静脉插管,并测量外周血和腺静脉样本中的睾酮、双氢睾酮、δ4 - 雄烯二酮、脱氢表雄酮及其硫酸盐、17α - 羟孕酮和皮质醇;测定外周血中的游离睾酮、雌二醇、雌酮、促黄体生成素(LH)、促卵泡生成素(FSH)和催乳素;促性腺激素释放激素(GnRH)和促甲状腺激素释放激素(TRH)双重刺激试验,以及地塞米松抑制试验。形态学、临床和内分泌变化之间没有相关性。未发现特定于PCO的激素模式。根据插管数据,46%的PCO病例存在卵巢 - 肾上腺联合雄激素分泌过多;单纯卵巢(21%)或肾上腺(12%)雄激素分泌过多的情况不太常见。动态功能试验结果显示无特异性;例如,地塞米松不仅抑制肾上腺,还抑制卵巢雄激素的分泌。从这些数据得出的结论是,PCO不是一个疾病实体,而是高雄激素血症的一个非必然标志。因此,腹腔镜检查对这些非肿瘤性高雄激素血症患者没有临床意义。