INDUCTION OF PUBERTY IN MEN BY LONG-TERM PULSATILE ADMINISTRATION OF LOW-DOSE GONADOTROPIN-RELEASING HORMONE
INDUCTION OF PUBERTY IN MEN BY LONG-TERM PULSATILE ADMINISTRATION OF LOW-DOSE GONADOTROPIN-RELEASING HORMONE
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DOI：
10.1056/nejm198211113072003
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
CROWLEY, WF
中科院分区：
文献类型：
--
作者：
HOFFMAN, AR;CROWLEY, WF
促性腺激素分泌的出现预示着青春期的到来。患有特发性低促性腺激素性性腺功能减退症的男性促性腺激素释放异常，并且不能经历正常的青春期。由于特发性低促性腺激素性性腺功能减退症可能代表促性腺激素释放激素（GnRH）分泌紊乱，长期低剂量皮下注射可能会导致性腺功能减退症。 GnRH 通过便携式输液泵以间歇方式给药，用于在 6 名男性中建立正常的成人促性腺激素分泌模式。所有受试者均出现自发勃起、遗精和乳房压痛，这些均与血清睾酮水平升高相关（治疗前为 77.+-.13 ng/dl [平均.+-.SE]，治疗 1 个月后为 520.+-.182 ng；P < 0.001）。促性腺激素水平在治疗 1 周内升至成人正常范围，并在 14 天后升至超生理水平。治疗 43 周后，4 名患者的睾丸大小有所增加，3 名患者实现了精子发生。长期间歇性 GnRH 给药显然可以逆转特发性低促性腺激素性性腺功能减退症。
Puberty is heralded by the appearance of episodic gonadotropin secretion. Men with idiopathic hypogonadotropic hypogonadism have an abnormality in gonadotropin release and do not undergo normal puberty. Since idiopathic hypogonadotropic hypogonadism may represent a disorder of gonadotropin-releasing hormone (GnRH) secretion, long-term low-dose s.c. GnRH, administered in an episodic fashion by a portable infusion pump, was used to establish a normal adult pattern of gonadotropin secretion in 6 men. All subjects noted spontaneous erections, nocturnal emissions and breast tenderness, which were associated with elevations of serum testosterone levels (77 .+-. 13 ng/dl [mean .+-. SE] before therapy vs. 520 .+-. 182 ng after 1 mo. of treatment; P < 0.001). Gonadotropin levels rose to normal adult ranges within 1 wk of therapy and to supraphysiologic levels by 14 days. Testis size increased in 4 patients, and spermatogenesis was achieved in 3 patients by 43 wk of therapy. Long-term episodic GnRH administration apparently can reverse idiopathic hypogonadotropic hypogonadism.