Leppäluoto J, Rönnberg L, Ylöstalo P
Acta Endocrinol (Copenh). 1983 Sep;104(1):1-5.
Seven patients suffering from severe endometriosis were treated with danazol 200 mg X 3 daily for 6 months. Clinical symptoms were alleviated and menses disappeared in response to the treatment. After cessation of the treatment the menstrual bleedings returned in 1-3 months. Blood samples for determination of gonadotrophins, prolactin (Prl), oestradiol (E2), progesterone, thyroid hormones and thyrotrophin in radioimmunoassays were taken and a combined TRF and LRF test carried out in the follicular phase before treatment, at the 6th month of treatment and after reappearance of the first menses. There were no statistically significant changes in the basal levels of serum FSH, LH or TSH during the danazol treatment. Neither was there any change in episodic secretions of FSH, LH or Prl, as determined by the mean coefficients of variation of the hormone levels in seven consecutive samples taken at 20 min intervals. On the other hand, serum E2, Prl and thyroid hormone levels were significantly decreased in the 6th month of treatment. In the TRF-LRF test the responses of serum FSH and LH were significantly higher and those of serum Prl and TSH significantly lower during danazol treatment than before. Prl responses remained lowered after the treatment. It appears that low serum oestrogen levels, induced by the danazol treatment, sensitize the pituitary gonadotrophs to exogenous LRF, but make the sensitivity of thyrotrophs and lactotrophs lower to exogenous TRF. These results thus indicate that danazol does not make the pituitary gonadotrophs insensitive to LRF, but danazol may rather inhibit the secretion of hypothalamic LRF.
7例重度子宫内膜异位症患者接受达那唑治疗,剂量为200mg,每日3次,共6个月。治疗后临床症状缓解,月经消失。停药后1 - 3个月月经复潮。在治疗前的卵泡期、治疗第6个月以及首次月经复潮后,采集血样进行放射免疫测定,以检测促性腺激素、催乳素(Prl)、雌二醇(E2)、孕酮、甲状腺激素和促甲状腺激素,并进行促甲状腺激素释放因子(TRF)和促黄体生成素释放因子(LRF)联合试验。达那唑治疗期间,血清促卵泡生成素(FSH)、促黄体生成素(LH)或促甲状腺激素(TSH)的基础水平无统计学显著变化。通过每隔20分钟采集的7个连续样本中激素水平的平均变异系数测定,FSH、LH或Prl的脉冲式分泌也无变化。另一方面,治疗第6个月时血清E2、Prl和甲状腺激素水平显著降低。在TRF - LRF试验中,达那唑治疗期间血清FSH和LH的反应显著升高,而血清Prl和TSH的反应显著降低。治疗后Prl反应仍较低。看来达那唑治疗诱导的低血清雌激素水平使垂体促性腺细胞对外源性LRF敏感,但使促甲状腺细胞和催乳细胞对外源性TRF的敏感性降低。因此,这些结果表明达那唑不会使垂体促性腺细胞对LRF不敏感,而是达那唑可能抑制下丘脑LRF的分泌。