雌二醇对去势前列腺癌患者LH脉冲分泌的抑制作用

THE INHIBITORY ACTION OF THE PULSATILE LH SECRETION IN CASTRATED MEN WITH PROSTATIC CARCINOMA

3例前列腺癌施行双侧睾丸切除术后2～12周的患者,每天肌注苯甲酸雌二醇1mg,连续7d。治疗前后分别每10min采血一次,作7h LH脉冲分析。结果表明,3例患者平均血清LH水平分别由177.58±3.20、138.30±5.83和145.88±3.82IU/L下降到174.90±7.60、132.02±5.77和142.80±3.65IU/L(P均<0.01),但LH脉冲幅度和频率无明显变化(P均>0.05)。其中,2例患者连续口服已烯雌酚2mg/日约1年后,平均血清LH明显被抑制(均≤5IU/L),LH脉冲消失。结论:(1)E_2不仅能抑制LH脉冲幅度,而且能抑制脉冲频率。表明E_2对下丘脑和垂体均有反馈作用;(2)E_2对LH脉冲的抑制作用有赖于长期的E_2用药。

Three patients with prostatic carcinoma who experienced bilateral orchidectomy 2 to 12 weeks ago were examined, and each patient accepted intramuscular injection of estradiol benzoate (E2B) in dose of 1 mg daily for 7 days. Blood sampe was drawn in an interval of 10 min was done for LH pulse analysis before and after the injection for a period of 7h. The results showed that the mean serum LH level decreased significantly from 177,58±3.20 to 174.70±7.60, 138.30±5.83 to 132.02± 5.77 and 145.88± 3.82 to 142.80± 3.65U / L, respectively (P<0.01 in all), whereas the LH pulse amplitude and pulse frequency were not (P<0.05 in all). Two of three patients continued to take diaethyst ilestrol 2 mg daily for about one year, and the mean serum LH level (all <5 U / L) was significantly suppressed and LH pulses completely disappeared. It was concluted that (1) E2 was not only able to suppress the LH pulse amplitude but also pulse frequency in men, suggesting a feedback effect of E2 on both hypothalamus and pituitary; (2) the inhibiting action of E-, on LH pulsatile secretion is dependent on a prolonged use of E2.