Botella-Llusiá J, Tresguerres J A, Vaticón M D, Ruiz-González M C, Martin-Santos F J, Guadalix F J, Novo Dominguez A
Ann Endocrinol (Paris). 1978;39(6):439-49.
Comparative results of the suppression-stimulation test by dexamethasone and chorionic gonadotropin, chromatographic separation of 17-ketosteroids, and plasma testosterone levels in the ovarian and adrenal veins, in cases of virilism in women. Thirteen patients with hirsutism and virilization were investigated as follows: 1. measurement of plasma testosterone (T) levels by radioimmunoassay (RIA) during suppression-stimulation tests by the administration of Dexamethasone (DXM) and chorionic Gonadotropin (HCG). 2. chromatographic determination of urinary 17-ketosteroids, pregnanediol (P2), and pregnanetriol (P3). An attempt was made to classify virilism as "ovarian" or "adrenal" based on the results of 1. and 2. 3. bilateral ovarian and adrenal venous catheterization through the femoral vein to measure T (RIA) levels. 4. laparotomy with bilateral wedge resections of the ovaries for therapeutic and biopsy purposes. Surgical catheterization of the ovarian veins was carried out during the operation. The results of these tests show that: a) the dynamic DXM-HCG test can be used to separate those cases in which the ovary is not involved in T formation from those in which, apparently, it is involved. b) chromatographic determination of urinary steroids has no aetiological value, as the variations in the different fractions are not significant. c) in all patients, the principal source of T is the adrenals and not the ovaries, even when there is an increase in T in the ovarian efferent blood vessels.
女性男性化病例中地塞米松和绒毛膜促性腺激素抑制 - 刺激试验的比较结果、17 - 酮类固醇的色谱分离以及卵巢静脉和肾上腺静脉中的血浆睾酮水平。对13例多毛症和男性化患者进行了如下研究:1. 在给予地塞米松(DXM)和绒毛膜促性腺激素(HCG)进行抑制 - 刺激试验期间,通过放射免疫测定法(RIA)测量血浆睾酮(T)水平。2. 对尿中17 - 酮类固醇、孕二醇(P2)和孕三醇(P3)进行色谱测定。试图根据1和2的结果将男性化分为“卵巢性”或“肾上腺性”。3. 通过股静脉进行双侧卵巢和肾上腺静脉插管以测量T(RIA)水平。4. 为治疗和活检目的进行双侧卵巢楔形切除术的剖腹手术。手术期间对卵巢静脉进行手术插管。这些测试结果表明:a)动态DXM - HCG试验可用于区分卵巢不参与T形成的病例和明显参与T形成的病例。b)尿类固醇的色谱测定没有病因学价值,因为不同组分的变化不显著。c)在所有患者中,T的主要来源是肾上腺而非卵巢,即使卵巢输出血管中的T有所增加。