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[青春期延迟与低促性腺激素性性腺功能减退:使用氯丙嗪催乳素刺激试验进行鉴别诊断]

[Delayed puberty and hypogonadotrophic hypogonadism: differential diagnosis with prolactin stimulation probe with chlorpromazine].

作者信息

Torrealba I M, Beas L F

机构信息

Instituto Materno Infantil, Hospital San Borja Arriarán, Santiago de Chile.

出版信息

Rev Med Chil. 1995 Dec;123(12):1477-83.

PMID:8733264
Abstract

We studied the changes in plasma levels of prolactin after an intramuscular injection of 0.33 mg/kg chlorpromazine and changes in plasma levels of LH and FSH after the injection of 100 micrograms iv GnRH, in 16 patients with delayed puberty, 10 patients with hypogonadotrophic hypogonadism and 6 healthy controls. Prolactin response was significantly lower in patients with hypogonadotrophic hypogonadism compared to subjects with constitutional delayed and healthy controls (delta Prolactin 7.05 +/- 1.7, 28.9 +/- 2.7 and 22.0 +/- 3.4 ng/ml respectively). LH response to GnRH was also lower in patients with hypogonadotrophic hypogonadism, compared to the other two groups (delta LH 4.3 +/- 2.5, 13.4 +/- 5.4 and 17.2 +/- 4.8 mUI/ml respectively) however, there was a great overlapping of values. No differences between groups were observed in responses of FSH, testosterone and estrogens to GnRH. It is concluded that prolactin response to chlorpromazine is useful in the differential diagnosis of constitutional delayed puberty.

摘要

我们研究了16例青春期延迟患者、10例低促性腺激素性性腺功能减退患者及6名健康对照者在肌内注射0.33mg/kg氯丙嗪后血浆催乳素水平的变化,以及静脉注射100μg促性腺激素释放激素(GnRH)后血浆促黄体生成素(LH)和促卵泡生成素(FSH)水平的变化。与体质性青春期延迟患者及健康对照者相比,低促性腺激素性性腺功能减退患者的催乳素反应显著降低(催乳素变化量分别为7.05±1.7、28.9±2.7和22.0±3.4ng/ml)。与其他两组相比,低促性腺激素性性腺功能减退患者对GnRH的LH反应也较低(LH变化量分别为4.3±2.5、13.4±5.4和17.2±4.8mUI/ml),然而,数值有很大重叠。在FSH、睾酮和雌激素对GnRH的反应方面,未观察到组间差异。结论是,氯丙嗪刺激催乳素反应有助于体质性青春期延迟的鉴别诊断。

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