性腺激素在绝经和继发性闭经中水平的对比研究

Study on the Differences Between the Serum Sex Hormones Levels in Menopausal Women and Patients with Secondary Amenorrhea

目的:探讨性腺激素在绝经与继发性闭经中的不同变化特点,评价卵巢功能,为二者的鉴别诊断和临床治疗提供依据。方法:采用放射免疫分析对40例正常月经者(1组)、40例绝经者(2组)及40例继发性闭经者(3组)的血清性腺激素进行测定,并相互对比各组检测结果。结果:2组FSH和LH值高于1组和3组,其中3组高于1组,E2反之;1组和2组PRL值水平接近,但二者明显低于3组;2组P值低于1组和3组,1组和3组水平接近;1组和3组t值相近,二者均高于2组。结论:绝经期卵巢萎缩伴卵巢功能衰竭,继发性闭经多为HPOU(下丘脑-垂体-卵巢-子宫)轴、肾上腺轴和甲状腺轴功能失调所致,卵巢功能尚存。

Objective To assess the differences between the ovarian function in menopausal women and patients with secondary amenorrhea with measurement of serum sex hormones levels. Methods Serum FSH, LH, E2 prolactin, progesterone and testosterone levels were measured with RIA in： ① 40 women with normal menstration ② 40 menopausal women and ③40 patients with secondary amenorrhea. Re.quits Among the three groups, the serum FSH and LH levels wre highest in the menopausal women with secondary amenorrhea patients the next. On the contrary, the serum E2 levels were lowest in the menopausal women with secondary amenorrhea patients the next. The sreum prolactin levels in women with normal menstruation and menopausal women were about the same and both were significantly lower than those in patients with secondary amenorrhea. The serum progestrone levels were extremely low in menopausal women （0.63 ±0.39 ng/ml）, while the levels in patients with secondary menopause were only moderately decreased （4.91 ±2. 83 ng/ml vs 11.26 ±4.51 ng/ml in women with normal menstrnation）, indicating possible presence of ovulation. Testosterone levels were also lowest in menopausal women. Conclusion Ovarian atrophy with functional failure was present in menopausal women. Secondury amenorrhea was usually due to dysfunction of hypothalamus - pituitary - ovary - uterus axis （ HPOV axis） with rentention of ovarian function.