促性腺激素治疗男性低促性腺激素性性腺功能减退症的疗效评估

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1、维普资讯http://www.cqvip.com·836·2005年l1月第44卷第11期ChinJInternMed—November2005，Vol4，No．1l．论著．促性腺激素治疗男性低促性腺激素性性腺功能减退症的疗效评估狄福松崔毓桂贾悦【摘要】目的应用人绒毛膜促性腺激素(hCG)和绝经期妇女尿促性腺激素(HMG)治疗男性低促性腺激素性性腺功能减退症，评价其疗效。方法64例低促性腺激素性性腺功能减退症患者中Kallmann综合征19例，特发性低促性腺激素型性腺功能低下41例，颅咽管瘤手术后性腺功能低下症4例。33例患者采用h

2、CG1500IU肌肉注射，每周2次；31例患者采用hCG1500IU+HMG75IU联合肌肉注射，每周2次。疗程均6个月以上。结果治疗后所有患者体力改善，体质增强；42例患者出现胡须、阴毛和(或)腋毛。睾丸体积治疗前(3．08±2．44)ml，治疗后(8．92±5．37)ml(P<0．01)；血清卵泡刺激素、黄体生成素和睾酮水平有所提高(P<0．05)；6／64患者出现遗精现象，2例有精子生成。以睾丸体积增大为判断疗效的标准，12例无效，52例有效，有效率达81．2％，hCG+HMG组效果明显好于hCG组。结论对男性低促性腺激素性性

3、腺功能减退症患者，用hCG和HMG治疗能促进青春期第二性征发育，体力增加，外生殖器和睾丸进一步发育，并可望部分恢复睾丸产生雄激素和生成精子两项功能，明显优于以往单纯使用或者过早使用雄激素替代的治疗方案。【关键词】性腺功能减退症；促性腺素类；青春期TheappMcafionofgonadotropinintreatmentofmslecentralhypogonadismDIFu-song，CUIYu一，JIAYue．DepartmentofEndocrinologyandKeyLaboratory，TheFirstAffiliate

4、dHospitalofNanjingMedwalUniversity，Nanjing210029，ChinaCorrespondingauthor：CUIru-s,~i，Email：cuiygn]@njmu．edu．cn【Abstract】ObjectiveToobservetheeficacyofhumanchorionicgonadotrophin(hCG)andhCGplushumanmenopausalgonadotropin(HMG)forcentralhypogonadisminmalepatients．Methods6

5、4menwithcentralhypogonadismwererecruitedinthisstudy，including19patientswithKallmannsyndrome，41patientswitllidiopathichypogonadotrophichypogonadism(IHH)and4patientswithhypogonadismafterbrainsurge~．33patientsweretreatedwithhCG1500IUintramuscularlytwiceaweek，whereas31pati

6、entsweretreatedwithintramuscularhCG1500IUplusHMG75IUtwiceaweek，foratleast6months．ResultsAftertreatment，allpatientsfeltstrongerphysicallyand42／64patientsdevelopedbeard，pubesorarmpithair．Thetestisvolumeenlargedsignificantly[(3．08±2．4)mlVS(8．92±5．37)ml，P<0．001]，andserumfo

7、llicle-stimulatinghormone，luteinizinghormoneandtestosteroneconcentrationswerehighersignificantlythanthosebeforetreatment(P<0．05)．6／64patientsunderwentspermatorrheaand2patientwerefoundtohavespermatogenesis．Ifjudgedbythetestisvolume，52patients(81．2％)wereefectiveand12pati

8、entswereinefective．ConclusionsFormalepatientswiththecentralhypogona&sm，hCGandhCGplusHMGcanpromotetllepubertaldevelopm