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肾上腺在多囊卵巢综合征(PCOS)发病中的作用是一个有争议的问题。作者提出,部分PCOS患者的原发病变是肾上腺雄激素分泌异常而引起高雌酮血症,随后导致促性腺激素分泌及卵巢异常。本文首先报导了PCOS患者采用甲吡酮抑制11-β羟化酶,使血皮质醇合成受阻,ACTH及相关肽类分泌增加时肾上腺雄激素及11-去氧皮质醇对内源性ACTH的反应亢进。本文还显示,长期使用小剂量地塞米松抑制肾上腺雄激素分泌,使2/3患者恢复了月经。试验者分二组:(1)PCOS患者19例。均有多毛及无排卵,其中15例月经稀发,4倒闭经。盆腔及/或超产检查符合PCOS。血浆睾酮(T)、睾酮/性激素结合蛋白比(T/SHBG)、雄烯二酮、17-羟孕酮、雌酮均增高,去氢表雄酮(DHEA)及其硫酸盐(Ds)、LH基值及雌二醇正常,血浆FSH降低,LH对LHRH的反应性增高。(2)正常月经早卵泡期妇女40例。观察项目包括:(1)19例PCOS患者及20例正常妇女行甲吡酮试验。方法为:30mg/kg,午夜0时一次口服,次日上午8—9时测定血浆11-去氧皮质醇和雄激素。(2)15例PCOS妇女用地塞米松0.5mg、每晚1次共3个月,服药后观察血浆各种激素浓度的变化
The role of the adrenal in the pathogenesis of polycystic ovarian syndrome (PCOS) is a matter of debate. The authors suggest that the primary lesion in some patients with PCOS is the abnormal secretion of androgen in the adrenal glands leading to hyperoesceremia followed by gonadotropin secretion and ovarian abnormalities. In this paper, we first report the response of adrenocorticotropic hormone and 11-deoxycortisol to endogenous ACTH in PCOS patients treated with metyrapone for inhibition of 11-beta hydroxylase, inhibition of blood cortisol synthesis, and increased secretion of ACTH and related peptides Kang. This article also shows that long-term use of low-dose dexamethasone inhibits adrenal androgen secretion, leaving 2/3 patients with menstruation. Test subjects were divided into two groups: (1) PCOS patients in 19 cases. Both have hirsutism and anovulation, of which 15 cases of menstrual thin hair, 4 collapse by. Pelvic and / or overproduction checks are in line with PCOS. The levels of plasma testosterone (T), testosterone / sex hormone binding protein (T / SHBG), androstenedione, 17-hydroxyprogesterone and estrone both increased, DHEA and its sulfate LH basal and estradiol normal, plasma FSH decreased LH LHRH reactivity increased. (2) Normal menstruation follicular phase of 40 women. Observations include: (1) 19 cases of PCOS patients and 20 normal women under the line of methadone test. Method: 30mg / kg orally at 0 o’clock once a day, the next day at 8-9 am determination of plasma 11-deoxy cortisol and androgen. (2) 15 cases of PCOS women with dexamethasone 0.5mg, 1 times a night for a total of 3 months after taking the drug changes in plasma concentrations of various hormones