Rudolf K, Kunkel S, Sudik R, Rüting M, Rohde E
Zentralbl Gynakol. 1985;107(16):996-1002.
In 8 patients with hypothalamic primary amenorrhea aged from 16 to 23 years (average age 19,4 years) a sequential stimulations test was performed with 0,5 g arginine hydrochloride per kg body weight, 25 micrograms gonadotropin-releasing hormone (GnRH) and 200 micrograms thyreotropin-releasing hormone (TRH). The response of the lactotropic, gonadotropic, thyreotropic and somatotropic cells of the pituitary was investigated. Serum levels of PRL, LH, FSH, TSH and HGH were determined by RIA. In all women hypoplastic ovaries were found by laparoscopy. In 7 patients tissue biopsies showed primordial follicles or primordial and secondary follicles, respectively. Investigations point to, that in hypothalamic primary amenorrhea at first the function of the gonadotropic and lactotropic cells of the pituitary is injured. The somatotropic cells could not be stimulated in 3 of 8 patients, the function of hypothalamo-pituitary-thyroid-axis in the stimulations test was normal in all women.
对8例年龄在16至23岁（平均年龄19.4岁）的下丘脑性原发性闭经患者，进行了序贯刺激试验，分别给予每千克体重0.5克盐酸精氨酸、25微克促性腺激素释放激素（GnRH）和200微克促甲状腺激素释放激素（TRH）。研究了垂体的催乳细胞、促性腺细胞、促甲状腺细胞和生长激素细胞的反应。采用放射免疫分析法测定血清催乳素（PRL）、促黄体生成素（LH）、促卵泡生成素（FSH）、促甲状腺激素（TSH）和生长激素（HGH）水平。通过腹腔镜检查发现所有患者卵巢发育不全。7例患者的组织活检分别显示有原始卵泡或原始卵泡和次级卵泡。研究表明，下丘脑性原发性闭经首先损伤的是垂体促性腺细胞和催乳细胞的功能。8例患者中有3例的生长激素细胞未被刺激，所有女性在刺激试验中下丘脑-垂体-甲状腺轴功能正常。
