急性白血病化疗对垂体、性腺、甲状腺激素的影响

Effects of Acute Leukemia Chemotherapy to Pituitary,Gonad,Thyroid Hormones

目的评价儿童急性白血病(AL)及联合化疗对其垂体、性腺、甲状腺激素的影响。方法测定37例(男23例,女14例)AL患儿化疗前后和20例对照组血清促卵泡激素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)、催乳素(PRL)、生长激素(GH)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平。结果AL患儿FSH、LH、T、E2、GH、FT4、TSH水平化疗前后及对照组各组差异无显著意义(P>0.05),PRL水平治疗前高于对照组(P<0.01),男童PRL水平治疗前后比较差异有显著意义(P<0.01)。FT3治疗前低于对照组(P<0.001),治疗后趋于正常(P>0.05)。结论AL本身及联合化疗对患儿垂体-性腺轴功能及GH水平无明显影响。AL本身可使PRL水平升高,而化疗药物可抑制男童PRL的分泌。联合化疗对甲状腺功能无影响,FT3水平对判断AL患儿病情变化、疗效及预后有一定参考意义。

Objective To evaluate the effect of acute leukemia（AL） and combination of chemotherapy on pituitary, gonad and thy roid hormones of children. Methods We measured plasma levels of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone（T）, E2, PRL, GH, thyroid - stimulating hormone （TSH）, free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ） in 37 acute leukemia children （14 girls and 23 boys） before and after chemotherapy and 20 contrast children. Results The plasma levels of hor monks, GH, TSH, FT4 were not significantly different before and after chemotherapy compared to control group（P 〉 0.05）. The plasma level of PRL before chemotherapy was higher than control group（P 〈 0.01 ）. The differences between the plasma levels of PRL of boys before and after chemotherapy had significance（P 〈 0.01 ）. But the plasma level of FT3 before chemotherapy was lower than contrast group（P〈0. 001 ）and up to normal after chemotherapy. Conclusions AL itself and the combination of chemotherapy have no evi denced infection on pituitary - gonad axis function and the plasma levels of GH. AL itself may raise the plasma level of PRL while chemotherapy medicine may have re,stralning infection on secretion of PRL. The combination of chemotherapy has no infection on thyroid function. Therefore the plasma level of FT3 has certain reference value to the estimation of illness state, effect of treatment and prognostic of acute leukaemia children.