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目的 探讨藏族男性肝病患者下丘脑 垂体 性腺轴的变化 ,了解不同类型肝病患者性腺激素水平的变化 ,协助临床对病情和预后的判断。方法 于 1999- 12～ 2 0 0 4 - 0 4在西藏自治区第二人民医院随机选择西藏地区藏族男性肝病患者 93例 ,包括甲型肝炎、乙型肝炎、酒精性肝病、肝硬化及重症肝炎。同时选取西藏地区 19名健康藏族男性作为对照。测定入选者睾酮 (T)、雌二醇 (E2 )、卵泡刺激素 (FSH)、黄体生成素 (LH )、泌乳素(PRL)及促性腺激素释放激素 (LHRH)的水平。资料统计采用双侧 t检测。结果 肝病患者E2 、PRL和LHRH水平与对照组比较均有显著性差异 (P <0 0 1、P <0 0 1、P <0 0 5 )。急性肝炎T、E2 、PRL升高 ,E2 升高 (P <0 0 1、P <0 0 5、P <0 0 1)。出现高雌激素血症和低睾酮血症 :重症肝炎T、FSH、LH、LHRH降低 (P <0 0 1、P<0 0 5、P <0 0 5、P <0 0 1) ,E2 、PRL升高 ,均为P <0 0 1。结论 性激素水平的变化与肝功能受损程度相一致 ,因此临床上测定性激素水平对了解病情、判断预后有着一定的作用。
Objective To investigate the changes of the hypothalamic pituitary gonadal axis in Tibetan male patients with liver diseases and to understand the changes of gonadal hormones in patients with different types of liver diseases so as to help clinical judgment of disease and prognosis. Methods Ninety-three Tibetan male patients with liver diseases were randomly selected from the Second People’s Hospital of Tibet Autonomous Region from December 1999 to December 2004, including hepatitis A, hepatitis B, alcoholic liver disease, cirrhosis and severe hepatitis. At the same time, 19 Tibetan healthy men in Tibet were selected as the control. Participants were tested for levels of testosterone (T), estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and gonadotrophin releasing hormone (LHRH) Data statistics using bilateral t test. Results The levels of E2, PRL and LHRH in liver disease patients were significantly different from those in control group (P <0.01, P <0.01, P <0.05). The levels of T, E2 and PRL increased and E2 increased in acute hepatitis (P <0.01, P <0.05, P <0.01). Hyper-estrogenmia and hypo-testosteronemia were found: the levels of T, FSH, LH and LHRH in severe hepatitis were decreased (P <0.01, P <0.05, P <0.05, P <0.01) PRL increased, both P <0 0 1. Conclusions The changes of sex hormones are consistent with the degree of impaired liver function. Therefore, the determination of sex hormones in clinic may play an important role in understanding the disease and prognosis.