Bahnsen M, Gluud C, Johnsen S G, Bennett P, Svenstrup S, Micic S, Dietrichson O, Svendsen L B, Brodthagen U A
Eur J Clin Invest. 1981 Dec;11(6):473-9. doi: 10.1111/j.1365-2362.1981.tb02016.x.
In forty-two patients with alcoholic liver cirrhosis and without recent alcohol ingestion the pituitary-testicular function was studied in an effort to relate the endocrine abnormalities with the degree of liver cell dysfunction, evaluated on a quantitative basis. Compared with values in twenty-one healthy controls, we found significantly elevated serum oestrone, oestradiol, follicle-stimulating hormone, luteinizing hormone and prolactin (P less than 0.01). Serum dehydro-epiandrosterone and dehydroepiandrosterone sulphate were significantly reduced in the cirrhotics (P less than 0.01), whereas serum testosterone was not significantly different from that in the controls. Raised levels of sex-hormone binding globulin were found in 71% (22/31) of the patients (median 8 x 10(-18) mol/l, range 3-17 x 10(-8) mol/l). The incidence of gynaecomastia (38%), cutaneous spiders (67%), testicular atrophy (24%) and reduced axillary hair (71%) was without significant relation to raised levels of sex-hormone binding globulin or progressively reduced liver function. In the presence of clinical or hormonal hypo-gonadism we found evidence of a state of primary hypogonadism together with an inadequate secretion of gonadotropins. The state of hyperoestrogenaemia and the concentration of gonadotropins were significantly correlated to the hepatic synthesis of coagulation factors.
对42例酒精性肝硬化且近期未摄入酒精的患者进行垂体 - 睾丸功能研究，旨在将内分泌异常与定量评估的肝细胞功能障碍程度相关联。与21名健康对照者的值相比，我们发现血清雌酮、雌二醇、促卵泡激素、促黄体生成素和催乳素显著升高（P<0.01）。肝硬化患者血清脱氢表雄酮和硫酸脱氢表雄酮显著降低（P<0.01），而血清睾酮与对照组无显著差异。71%（22/31）的患者出现性激素结合球蛋白水平升高（中位数8×10⁻¹⁸mol/L，范围3 - 17×10⁻⁸mol/L）。男性乳房发育（38%）、蜘蛛痣（67%）、睾丸萎缩（24%）和腋毛减少（71%）的发生率与性激素结合球蛋白水平升高或肝功能逐渐减退无显著关联。在存在临床或激素性性腺功能减退的情况下，我们发现存在原发性性腺功能减退状态以及促性腺激素分泌不足的证据。高雌激素血症状态和促性腺激素浓度与凝血因子的肝脏合成显著相关。
