正常月经周期卵泡生长对应性激素变化的临床监测

Clinical monitoring of serum sex hormones during normal menstrual follicle growth cycle

目的研究中国育龄妇女规律月经周期中卵泡生长对应性激素的变化特点。方法收集北京协和医院2010年9月30名月经规律的中国育龄妇女，平均年龄（28.8±3.2）岁，每日空腹采集血液，利用新一代全自动化学发光免疫分析仪检测6种性激素：卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、孕酮（P）、睾酮（T）、泌乳素（PRL），同时每日进行阴道超声下卵泡监测。采用非参数法进行结果统计分析。结果所有对象月经周期为25～39 d，平均（29.5 ± 3.1）d，卵泡期和黄体期分别为15.3 d和14.4 d，窦卵泡到优势卵泡出现及优势卵泡排卵分别为6.2 d和8.9 d，排卵前卵泡平均直径19.33 mm，排卵前出现FSH、LH峰值；排卵前P值开始升高，排卵后黄体期第6～9天P值维持高水平稳定状态。围排卵期PRL及T都出现一个小高峰。结论LH及P水平在排卵前1～2 d即开始有小幅升高，预示卵泡即将成熟。PRL及T随着卵泡的生长也呈周期性改变，应在早卵泡期评估基础状态。（中华检验医学杂志，2017, 40：169－173）

Objective To study the changes of six sex hormones corresponding to the follicle growth during the normal menstrual cycle of Chinese women. Methods Thirty Chinese women with regular menstrual period and average age of （28.8 ±3.2） years were selected for the study by Peking Union Medical College Hospital in September, 2010. Growth of follicles was monitored by using transvaginal sonography. Six sex hormones, including follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （ E2 ）, progesterone （P）, testosterone （T）, and prolactin （PRL） were measured by chemol immunoassay every day during a menstrual cycle. Nonparametric statistical analysis was used. Results Menstrual cycle of all the patients was in the range of 25 to 39 d, with mean of （29. 5 ± 3.1 ） d. Length of follicular phase and luteal phase was 15.3 and 14.4 d, respectively. Number of days from antral follicle to emergence of dominant follicle, and from the latter to ovulation, was 6. 2 and 8.9 d, respectively. Average diameter of preovulatory follicle was 19. 33 mm. Both FSH and LH reached peak on the day before ovulation. P started to increase before ovulation and remained at a high plateau from 6th to 9th day after ovulation. Both PRL and T reached peak after ovulation, near the end of a menstrual cycle. Conclusions A small rise of LH and P emerges just 1 to 2 d before ovulation, indicating the maturing of follicle. PRL and T shows cyclic changes as follicle grows. Therefore, PRL and T levels should be measured in the early follicle phases in the clinical practice so that leading the impact of menstrual cycle minimal. （ Chin J Lab Med, 2017, 40： 169- 173）