脉冲式注射LHRH诱发特发性低促性腺激素型性功能低下患者的精子发生

PULSATILE ADMINISTRATION OF LHRH INDUCED SPERMATOGENESIS IN PATIENTS WITH IDIOPATHIC HYPOGONADOTROPIC HYPOGONADISM

本文首次在国内用自制YED-1型自动注射泵脉冲式皮下注射LHRH(5μg/脉冲/90分)治疗4例低促性腺激素型性功能低下(IHH)。所有4例经治疗后症状明显改善,性激素水平明显提高,睾丸体积增大,其中2例达正常成年男子水平,并在治疗的第250和330天时精液中出现成熟精子,精子计数分别为4×10~6/ml和10×10~6/ml,第3例睾丸由治前的4ml增大到8ml。2例已结婚。第4例经治疗4个月,症状及激素水平明显好转后,出现耐药现象,血清T水平又下降到治疗前的极低水平,阴茎停止勃起,推测可能与出现抗LHRH抗体有关。

Four men with idiopathic hypogondotropic hypogonadism (IHH) were treated with pulsatile subcutaneous injection of LHRH (5 μg/pulse/90 min. ) by using a domestic made portable automatic pump by ourself. The clinical symptoms of hypogonadism and hormone profile were improved greatly. The testicular size increased significantly in three of the patients: approximated to that of normal adult men. Matured spermatozoa appeared in ejaculates of case 1 and 2 at 250 and 330 days after treatment with spermcount of 10×10~6/ml and 4×10~6/ml respectively. The testicular size in case 3 increased to 8 ml compared with pretreatment volume of 4 ml. Two patients have married and another one will be married soon. Significant improvement in both symptoms and hormone levels also found in the fourth patient during the first 4 month treatment, then a resistance to LHRH therapy occurred indicated by the decrease in T concentration and loss of the once recovered erection function. The resistance to continuation of pulsatie administration of LHRH might be due to the presence of anti-LHRH antibodies in the serum.