Hoffman A R, Crowley W F
N Engl J Med. 1982 Nov 11;307(20):1237-41. doi: 10.1056/NEJM198211113072003.
Puberty is heralded by the appearance of episodic gonadotropin secretion. Men with idiopathic hypogonadotropic hypogonadism have an abnormality in gonadotropin release and do not undergo normal puberty. Since idiopathic hypogonadotropic hypogonadism is thought to represent a disorder of gonadotropin-releasing-hormone (GnRH) secretion, we used long-term low-dose subcutaneous GnRH, administered in an episodic fashion by a portable infusion pump, in an effort to establish a normal adult pattern of gonadotropin secretion in six men. All subjects noted spontaneous erections, nocturnal emissions, and breast tenderness, which were associated with elevations of serum testosterone levels (77 +/- 13 ng per deciliter [mean +/- S.E.] before therapy vs. 520 +/- 182 ng after one month of treatment; P less than 0.001). Gonadotropin levels rose to normal adult ranges within one week of therapy and to supraphysiologic levels by 14 days. Testis size increased in four patients, and spermatogenesis was achieved in three patients by 43 weeks of therapy. These results suggest that long-term episodic GnRH administration can reverse idiopathic hypogonadotropic hypogonadism.
青春期以间歇性促性腺激素分泌的出现为标志。特发性低促性腺激素性性腺功能减退的男性存在促性腺激素释放异常，无法经历正常的青春期。由于特发性低促性腺激素性性腺功能减退被认为是一种促性腺激素释放激素（GnRH）分泌紊乱，我们使用便携式输液泵以间歇性方式长期皮下注射低剂量GnRH，试图在6名男性中建立正常的成年促性腺激素分泌模式。所有受试者均出现自发勃起、夜间遗精和乳房压痛，这些与血清睾酮水平升高有关（治疗前为77±13 ng/dl[平均值±标准误]，治疗1个月后为520±182 ng；P<0.001）。促性腺激素水平在治疗1周内升至正常成年范围，14天时升至超生理水平。4例患者睾丸大小增加，3例患者在治疗43周时实现了精子发生。这些结果表明，长期间歇性给予GnRH可逆转特发性低促性腺激素性性腺功能减退。
