论文部分内容阅读
目的初步了解中国汉族雄激素过多症女性中非经典型21-羟化酶缺乏症(NC-21OHD)的患病情况。方法对85例汉族雄激素过多症患者及14名健康女性进行卵泡期ACTH兴奋试验。结果雄激素过多组睾酮(T)、LH均显著高于正常对照组[(2.86±1.26vs1.11±0.48)nmol/L,(9.19±6.15vs2.71±1.89)U/L,均P<0.01];雄激素过多组中具有多囊卵巢综合征(PCOS)临床表现的有60例,占70.6%。根据ACTH兴奋试验结果诊断NC-21OHD3例,占雄激素过多组的3.5%(3/85)。除3例NC-21OHD外,雄激素过多组(n=82)0min血皮质醇(F0)显著高于正常对照组[(127.0±40.7vs106.2±14.8)μg/L,P<0.01];0min和60min17-OH孕酮(17-OHP0及17-OHP60)也显著高于对照组[(1.67±0.85vs0.66±0.29)μg/L,(3.98±1.32vs2.03±0.68)μg/L,均P<0.01],而60min血皮质醇(F60)没有明显差异[(252.6±28.9vs245.9±28.9)μg/L,P>0.05]。比较Δ17-OHP及Δ17-OHP/ΔF,雄激素过多组也均显著高于正常对照组[(2.30±1.07vs1.37±0.61)μg/L,(0.20±0.10vs0.10±0.05),均P<0.01]。结论85例雄激素过多症妇女中NC-21OHD为3例,占3.5%。ACTH兴奋试验对鉴别NC-21OHD与其它原因导致女性高雄激素血症有重要意义。
Objective To understand the prevalence of nonclassical 21-hydroxylase deficiency (NC-21OHD) in Chinese Han androgen-induced multiple women. Methods 85 patients with androgen overdose in Han and 14 healthy women were subjected to follicular ACTH stimulation test. Results The levels of testosterone (T) and LH in the hyperandrogenic group were significantly higher than those in the normal control group [(2.86 ± 1.26 vs 1.11 ± 0.48) nmol / L, (9.19 ± 6.15 vs 2.71 ± 1.89) U / L, P <0.01]. There were 60 cases with polycystic ovary syndrome (PCOS) clinical manifestations in over-androgen group, accounting for 70.6%. NC-21OHD3 cases were diagnosed according to the results of ACTH excitement test, accounting for 3.5% (3/85) of those with hyperandrogenism. Except for 3 cases of NC-21OHD, the level of serum cortisol (F0) was significantly higher in the androgen group (n = 82) at 0min compared with the control group [(127.0 ± 40.7 vs 106.2 ± 14.8) μg / L, P <0.01] ; Progesterone (17-OHP0 and 17-OHP60) at 0 and 60 min was also significantly higher than that of the control group [(1.67 ± 0.85 vs 0.66 ± 0.29) μg / L, (3.98 ± 1.32 vs 2.03 ± 0.68) μg / L, all P <0.01], but there was no significant difference in 60min blood cortisol (F60) [(252.6 ± 28.9vs245.9 ± 28.9) μg / L, P> 0.05]. Compared with normal control group [(2.30 ± 1.07vs1.37 ± 0.61) μg / L, (0.20 ± 0.10vs0.10 ± 0.05), compared with those of Δ17-OHP and Δ17-OHP / ΔF, All P <0.01]. Conclusions There are 3 cases of NC-21OHD in 85 cases of hyperandrogenism, accounting for 3.5%. ACTH stimulation test to identify NC-21OHD and other causes of female genital hyperandrogenism have important significance.