目的探讨功能性卵巢高雄(FOH)患者雌激素合成的影响因素。方法18例FOH,患者分为2组:双侧小卵泡(Ф2~8mm)数量为8~11的为FOHⅠ组(9例)。数量为12-24的为FOHⅡ组(9例)。8名正常妇女作为对照组。用人绝经期促性腺激素(150U)和绒毛膜促性腺激素(5000U)进行卵巢兴奋试验,试验后3,8,12,18,24h时检测血清睾酮(T)和雌二醇(E2)水平,计算芳香化酶功能状态和活性。结果3h时点FOHⅠ组E2水平显著高于对照组。而8,12,18,24h时点FOHⅡ组E2水平则显著高于FOHⅠ组,但芳香化酶功能状态和活性在各时点差异均无统计学意义。结论雄激素水平和卵泡数量均可影响卵巢兴奋试验后E2的合成,且具有协同作用,卵泡数量较多的患者对卵巢兴奋试验更加敏感。
Objective To investigate the factors influencing the estrogen production of functional ovarian hyperandrogenism. Methods 18 patients with functional ovarian hyperandrogenism (FOH) were divided into two groups according to the number of the follicles measuring 2--8mm in diameter, one group had 8 to 11 follicles together in two lateral ovaries (named as FOH Ⅰ ), and the other group had 12 to 24 (named as FOH Ⅱ ).Eight ovulatory females were recruited as controls. An ovary stimulation test with HCG and HMG was administered to evaluate the level of testosterone and estradiol (E2) in serum. Then, the functional state and functional activity of aromatase were calculated. Results At the 3 hours point after the ovary excitation, the serum E2 level of FOH Ⅰ was significantly higher than that of the control group, while at the 8, 12, 18, 24 hours point, the E2 level of FOH Ⅱ was significantly higher than that of FOH Ⅰ . The functional state and functional activity of aromatase had no difference among the groups. Conclusion Both a high level of testosterone and a more number of follicle can increase the synthesis of estrogen after the ovary excitation test. The sensitivity of FOH ovary to the ovary excitation test is higher when the follicle number is more.