中国临床医学2016，Vol.23Issue(4)：477-479,3.DOI:10.12025/j.issn.1008-6358.2016.20160808
小剂量雌激素在跌重性闭经患者排卵功能恢复中的应用
Effect of small dosage of estrogen on ovulation functional recovery of patients with weight-loss related amenorrhea
摘要
Abstract
Objective:To explore the effect of small dosage of estrogen on ovulation functional recovery of patients with weight‐loss related amenorrhea and clarify the variation of gonadotropin .Methods:The clinical data of 36 patients with weight loss‐related amenorrhea were collected and analyzed .The body mass index (BMI) before amenorrhea ,basic BMI (during amenorrhea) ,luteinizing hormone (LH)and luteinizing hormone‐releasing hormone (LHRH) provocation test data were collected .Clinical examination data of each period in estrogen treatment and LHRH provocation test data in each 6 months after treatment were collected .The basal body temperature was measured and serum progesterone was used to detect ovulation .The factors affecting the time of ovulation recovery were analyzed by statistic comparing .Results: Amone 36 patients ,20 cases were back to normal ovulation ,with the average time of (24 .1 ± 13 .6)months ,while the treatment period of estrogen replacement therapy in 16 non‐recovered cases was only (6 .65 ± 3 .36)months .Patients back to normal ovulation time was negatively correlated with former BMI (P<0 .01) and basal BMI (P=0 .04) .With the increasing of 1 kg/m2 of former BMI ,the treatment period can reduced 3 .6 months ,and the ovulation recovery time was reduced of 3 .1 months .In the 20 recovered patients ,arerage BMI of 17 patients increased (1 .92 ± 2 .11) kg/m2 ,2 patients did not change ,1 case was decreased of 0 .4 kg/m2 .The BMI variation of not recovered patients was not observed .The LH level was significantly increased of ([1 .2 ± 0 .4] mIU/mL vs [5 .6 ± 1 .6] mIU/mL , P= 0 .005) of patients back to normal ovulation .Area under the curve (AUC) of LH in LHRH provocation test was significantly increased (17 .1 ± 6 .3 vs 44 .6 ± 10 .1 ,P= 0 .027) .Conclusions:Weight loss‐related amenorrhea could restore ovulation by estrogen replacement therapy .L H self‐secretion level and reaction recovery of gonadotrophin releasing hormone are the key mechanism of the re‐build of the ovulation function .The former or basal BM I needs longer period to recover ovulation .关键词
雌激素替代治疗/跌重/闭经Key words
estrogen replacement therapy/weight loss/amenorrhea分类
医药卫生引用本文复制引用
李昕,薛晓红,徐晶晶,林金芳..小剂量雌激素在跌重性闭经患者排卵功能恢复中的应用[J].中国临床医学,2016,23(4):477-479,3.基金项目
上海市卫生局基金（20134264）．Supported by Foundoation of Shanghai Municipal Health Bureau （20134264）． （）
