Castelo-Branco C, Martínez de Osaba M J, Vanrezc J A, Fortuny A, González-Merlo J
Department of Gynaecology and Obstetrics, Hospital Clinic i Provincial, School of Medicine, University of Barcelona, Spain.
Maturitas. 1993 Sep;17(2):101-11. doi: 10.1016/0378-5122(93)90005-3.
The purpose of this study was to determine how oophorectomy and different hormone replacement therapy (HRT) regimens using low doses of medroxyprogesterone acetate (MPA, 2.5 mg/day) influence the pituitary-gonadal axis function. Ninety (90) women, who had had regular menses prior to surgery, completed a 1-year follow-up period. Patients were assigned to 5 groups. The first (n = 16) received 0.625 mg/day conjugated equine oestrogens (CEE) cyclically, the second (n = 20) 50 micrograms day transdermal oestradiol (E2) cyclically and the third (n = 15) 0.625 mg/day CEE continuously. These 3 groups also received 2.5 mg MPA sequentially for the last 12 days of HRT administration. The fourth group (n = 20) received 0.625 mg/day CEE and 2.5 mg/day of MPA continuously, while the fifth (n = 19) constituted a control group. After oophorectomy all patients showed increases in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and decreases in those of E2, oestrone (E1), prolactin (PRL), sex-hormone-binding globulin (SHBG), androstenedione (delta A4) and testosterone (T). No changes were detected in dehydroepiandrosterone sulphate (DHEA-S) levels. After HRT, decreases in FSH, LH and PRL levels and increases in those of E2, E1 and SHBG were observed, but no changes were seen in T, delta A4 or DHEA-S plasma levels. As the differences that were found cannot be attributed to the presence of ovaries, it is reasonable to assume that they were perhaps due to the treatment. All these changes, with the exception of a decrease in PRL levels, are therefore to be expected after HRT.
本研究的目的是确定卵巢切除术以及使用低剂量醋酸甲羟孕酮（MPA，2.5毫克/天）的不同激素替代疗法（HRT）方案如何影响垂体-性腺轴功能。90名在手术前月经规律的女性完成了为期1年的随访。患者被分为5组。第一组（n = 16）接受0.625毫克/天的结合马雌激素（CEE）周期性给药，第二组（n = 20）接受50微克/天的经皮雌二醇（E2）周期性给药，第三组（n = 15）接受0.625毫克/天的CEE持续给药。这3组在HRT给药的最后12天还依次接受2.5毫克MPA。第四组（n = 20）接受0.625毫克/天的CEE和2.5毫克/天的MPA持续给药，而第五组（n = 19）为对照组。卵巢切除术后，所有患者的促卵泡激素（FSH）和促黄体生成素（LH）水平升高，而E2、雌酮（E1）、催乳素（PRL）、性激素结合球蛋白（SHBG）、雄烯二酮（δA4）和睾酮（T）水平降低。硫酸脱氢表雄酮（DHEA-S）水平未检测到变化。HRT后，观察到FSH、LH和PRL水平降低，E2、E1和SHBG水平升高，但T、δA4或血浆DHEA-S水平未见变化。由于所发现的差异不能归因于卵巢的存在，因此合理推测它们可能是由于治疗所致。因此，除了PRL水平降低外，所有这些变化在HRT后都是可以预期的。
