A pilot study of the human chorionic gonadotrophin test for ovarian hyperandrogenism.
A pilot study of the human chorionic gonadotrophin test for ovarian hyperandrogenism.
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人绒毛膜促性腺激素测试卵巢雄激素过多症的初步研究。
DOI：
10.1093/humrep/12.7.1416
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Rosenfield,RL
中科院分区：
文献类型：
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作者：
Levrant,SG;Barnes,RB;Rosenfield,RL
一项对照临床研究旨在探讨人绒毛膜促性腺激素（HCG）挑战作为功能性卵巢高雄激素症的测试的价值。地塞米松给药后给予5000iu HCG，分别于用药后0、8、16、24 h取血进行类固醇激素检测。研究对象为正常女性（n = 13）；患有功能性卵巢雄激素分泌亢进症的女性，表现为雄激素过量、闭经和对纳伐林的17-羟孕酮反应增加（n = 6）；正常男性（n = 4）。17-羟孕酮、雄烯二酮和睾酮对功能性卵巢高雄激素症患者HCG的反应明显大于正常女性。然而，在功能性卵巢高雄激素症患者中，HCG治疗后17-羟孕酮对HCG的反应明显低于纳伐林治疗后。尽管正常女性和功能性卵巢高雄激素症女性的雌二醇浓度增加了一倍以上，但HCG治疗后雌二醇的反应也明显低于纳伐林。对HCG的反应证实功能性卵巢高雄激素异常是黄体生成素（LH）依赖性的。因此，17-羟孕酮对HCG的反应可以作为诊断卵巢高雄激素症的有用测试。功能性卵巢高雄激素症患者17-羟孕酮对HCG的反应低于对nafarelin的反应，提示卵泡刺激素（FSH）反应因子调节鞘膜17-羟孕酮的分泌。雌二醇对HCG的反应与HCG直接刺激鞘细胞分泌雌二醇一致。
A controlled clinical study was designed to investigate the value of human chorionic gonadotrophin (HCG) challenge as a test for functional ovarian hyperandrogenism. Dexamethasone administration was followed by 5000 IU HCG and blood samples for steroid hormone assay were obtained 0, 8, 16, and 24 h thereafter. Study subjects were normal women (n = 13); women with functional ovarian hyperandrogenism, defined by androgen excess, amenorrhoea and an increased 17-hydroxyprogesterone response to nafarelin (n = 6); and normal men (n = 4). The responses of 17-hydroxyprogesterone, androstenedione and testosterone to HCG in women with functional ovarian hyperandrogenism were significantly greater than in normal women. However, the 17-hydroxyprogesterone response to HCG in functional ovarian hyperandrogenism was significantly lower after HCG than after nafarelin. The oestradiol response was also significantly lower after HCG than nafarelin, although oestradiol concentration more than doubled in normal women as well as in women with functional ovarian hyperandrogenism. The responses to HCG confirm that functional ovarian hyperandrogenism abnormalities are luteinizing hormone (LH)-dependent. Therefore, the 17-hydroxyprogesterone response to HCG could represent a useful test for the diagnosis of ovarian hyperandrogenism. The lower 17-hydroxyprogesterone response to HCG than to nafarelin in functional ovarian hyperandrogenism suggests that a follicle-stimulating hormone (FSH)-responsive factor modulates thecal 17-hydroxyprogesterone secretion. The oestradiol response to HCG is consistent with HCG directly stimulating the oestradiol secretion by thecal cells.