Geisthövel W, von zur Mühlen A
Klin Wochenschr. 1978 Sep 15;56(18):929-35. doi: 10.1007/BF01489220.
In 27 male patients (age 31--60 years) with chronic hepatic diseases--10 of which with alcohol-toxic cirrhosis (ACi), 10 with hepatitic cirrhosis (HCi) and 7 with chronic aggressive hepatitis (CHAH)--total testosterone (T) and total oestradiol-17 beta (E2) in plasma were determined before and after HCG i.m. as well as LH and FSH before and 30 min and 60 min after LH-RH i.v. T, E2, LH and FSH were evaluated by specific RIA. Basal T was significantly decreased in ACi in comparison to normals and to HCi and CHAH. The increase after stimulation with HCG was reduced in all patient groups. Mean E2 before stimulation was altered in none of the groups compared to controls. After HCG there was an inadequate response only in ACi. Before as well as after stimulation with LH-RH, LH and FSH were increased in all patient groups. Our results point to the following: In males with chronic hepatic failure a testes insufficiency often occurs, which may depend on the etiology and the stage of the liver disease. An additional pituitary insufficiency appears not to exist.
对27例患有慢性肝病的男性患者(年龄31 - 60岁)进行了研究,其中10例为酒精性中毒性肝硬化(ACi),10例为肝炎后肝硬化(HCi),7例为慢性活动性肝炎(CHAH)。分别在肌肉注射人绒毛膜促性腺激素(HCG)前后测定血浆总睾酮(T)和总雌二醇 - 17β(E2),并在静脉注射促黄体生成素释放激素(LH - RH)前、注射后30分钟和60分钟测定促黄体生成素(LH)和促卵泡生成素(FSH)。采用特异性放射免疫分析法(RIA)对T、E2、LH和FSH进行评估。与正常组以及HCi和CHAH组相比,ACi组的基础T显著降低。所有患者组经HCG刺激后的升高均降低。与对照组相比,各刺激组刺激前的平均E2均无变化。HCG刺激后仅ACi组反应不足。在LH - RH刺激前后,所有患者组的LH和FSH均升高。我们的结果表明:在患有慢性肝衰竭的男性中,常出现睾丸功能不全,这可能取决于肝病的病因和阶段。似乎不存在额外的垂体功能不全。