Kawashima R, Douchi T, Oki T, Yoshinaga M, Nagata Y
Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Japan.
J Obstet Gynaecol Res. 1998 Oct;24(5):367-73. doi: 10.1111/j.1447-0756.1998.tb00110.x.
To investigate the etiology of menstrual disorders in patients undergoing chronic hemodialysis (CHD).
The menstrual histories, along with hormonal, biochemical, and hematological data, were investigated in 25 reproductive-aged CHD patients.
All subjects had had regular menstrual cycles before entering CHD therapy. Of the 20 women who developed amenorrhea after beginning CHD therapy, 8 showed a return to their regular cycles and 6 improved to oligomenorrhea, 3 months to 66 months later, while 6 remained amenorrheic. The serum prolactin (PRL) levels were significantly higher in the patients (n = 9) with normogonadotropic amenorrhea or oligomenorrhea than in patients (n = 13) with regular cycles (53.6 +/- 36.2 vs 27.8 + 15.2 ng/ml, p < 0.05). The serum LH levels were high in both groups. In a cross-sectional study, the serum PRL levels gradually decreased with longer duration of dialysis.
Patients undergoing CHD are likely to develop menstrual disorders. Hyperprolactinemia in part contributes to these menstrual disorders. However, menstrual disorders in CHD patients tend to improve during long-term follow-up, because of the gradual decrease in serum PRL levels during long-term CHD therapy.
探讨慢性血液透析（CHD）患者月经紊乱的病因。
对25例育龄期CHD患者的月经史以及激素、生化和血液学数据进行了调查。
所有受试者在开始CHD治疗前月经周期均规律。在开始CHD治疗后出现闭经的20名女性中，8名在3个月至66个月后月经周期恢复正常，6名改善为月经过少，而6名仍处于闭经状态。促性腺激素正常性闭经或月经过少患者（n = 9）的血清催乳素（PRL）水平显著高于月经周期正常患者（n = 13）（53.6±36.2 vs 27.8 + 15.2 ng/ml，p < 0.05）。两组患者的血清促黄体生成素（LH）水平均较高。在一项横断面研究中，血清PRL水平随着透析时间的延长而逐渐降低。
CHD患者容易出现月经紊乱。高催乳素血症部分导致了这些月经紊乱。然而，由于长期CHD治疗期间血清PRL水平逐渐降低，CHD患者的月经紊乱在长期随访中往往会有所改善。
