低促性腺激素性功能减退两种治疗方法的探讨

COMPARISON OF TWO METHODS FOR TREATING PATIENTS WITH ISOLATED HYPOGONADOTROPIC HYPOGONADISM

目的：观察低促性腺激素型性功能减退（IHH）患者应用两种治疗方法的效果。方法：5例IHH患者使用GnRH脉冲式给药或hCG＋TP肌注，定期测定血清中FSH、LH、T变化。结果：治疗过程中，血清FSH、LH、T均有所提高；治疗结束时，hCG组血清T比治疗前增加4.3倍，GnRH组增加1．9倍；睾丸容积比治疗前分别增加2．2倍和1．9倍。结论：两种疗法对改善IHH症状，提高血清T值水平均有效，hCG＋TP组短期效果优于GnRH，但GnRH脉冲治疗更符合生理规律。

Objective:To observe the effects of two methods for treating patients with isolated hypogonadotropic hypogonadisim(IHH). Methods:Five men with IHH were divided into two groups. Three patients were treated with im. hCG+TP,while the other two received pulsatile GnRH in dose of 5. 7 μg/pulsatile. 90min. FSH, LH, T in serum were measured every one or two months during the treatment.Results: Up to the end of therapy,the mean T levels increased 4. 3 fold compared with pretreatment levels in the hCG/TP-treated group,but only 1. 9 fold in GnRH-treated group,and the mean testicularvolumes were 2. 2 fold and 1. 7 fold higher, respectively, than the pretreatment valuse. Conclusion: Pulsatile sc. GnRH and im. HCG administrations were all effective in increasing T level and augmenting testicular growth in patients with IHH,although the latter was better. But pulsatile GnRH therapy closelymimicks normal physiological stimulation.