骨髓移植预处理对血液病患者性腺内分泌功能的影响

EFFECTOF BONE MARROW TRANSPLANTATIONCONDITIONING REGIMEN ON GONADAL FUNCTION INPATIENTS WITH BLOOD DISEASES

对３７例血液病患者骨髓移植（ＢＭＴ）前后进行了垂体－性腺功能检测。ＢＭＴ前患者性腺内分泌功能已受到一定程度的损害，女性患者血清卵泡刺激素（ＦＳＨ）水平与黄体生成素（ＬＨ）水平及男性患者ＦＳＨ水平高于正常对照组（Ｐ＜０．０５）。女性患者在ＢＭＴ后３～６０个月血清ＦＳＨ、ＬＨ水平均较ＢＭＴ前明显升高（Ｐ＜０．００１），雌二醇（Ｅ＿２）明显降低（Ｐ＜０．０１），１４例女性患者均闭经，已婚的５例女患者随访６个月以上均缺乏性欲；男性患者血清ＦＳＨ及ＬＨ水平分别在ＢＭＴ后３～３６个月及３～６个月明显升高，睾酮（Ｔ）明显降低（Ｐ＜０．０１），ＢＭＴ１２个月后血清ＬＨ及Ｔ水平恢复正常，已婚的７例男性患者随访６个月以上仅１例缺乏性欲。结果表明：ＢＭＴ后患者均发生性腺内分泌功能异常，近期恢复的可能性较小。

he pituitary-gonadal function changes were studiedin 37 patients with hematological diseases before andafter bone marrow transplantation(BMT).As com-pared with normal controls,serum FSH and LH levelsin female patients and FSH levels in male patients pre-BMT were significantly increased(P<0. 05 ) AfterBMT all 14 females became amenorrhea,and serumFSH and LH levels were furtber increased(P<0. 001)and serum E2 levels significantly reduced in 3 to 60months All 5 married women complained of loss of li-bido after BMT. While there was a significant increasein serum FSH levels in males in 3 to 36 months afterBMT, the serum LH levels were significantly increased(P<0. 001 ).The testosterone(T) was significantly re-duced (P<0.01)in males in 3 to 6 months,and theLH and T levels returned to normal in 12 to 3 6 monthspost-BMT, In contrast to females,only 1 of 7 marriedmen had sexual dysfunction.These results showed thatgonadal dysfunction existed in almost all patients post-BMT,and it is unlikely to return to normal in a shortperiod.