肝硬化患者性激素水平变化临床意义.docVIP

肝硬化患者性激素水平变化临床意义 　　[摘要] 目的 探讨性激素变化与肝硬化发生的关系。方法 采用放射免疫法检测80例肝硬化患者和20例健康男性(对照组)的血清性激素水平,并采用Child-pugh分级法将上述病例分为A级组、B级组和C级组进行比较。结果 各肝硬化组T、E2的平均水平均降低于正常对照组(P0.01),FSH、LH、PRL高于正常对照组(P0.01);Child分级与T、E2含量呈负相关(r=-0.55,r=-0.49,P0.05);与PRL、LH、FSH含量呈正相关(r=0.43,r=0.47,r=0.46,P0.05)。结论 肝硬化存在不同程度的性激素紊乱,测定性激素水平变化,可以作为临床判断预后、疗效的一个指标。 　　[关键词] 肝硬化; 性激素/睾酮; 雌二醇; 催乳素 　　[中图分类号] R657.3 [文献标识码] A [文章编号] 1673-9701(2010)01-05-02 　　 　　Clinical Significance of Changes in Sex Hormone Level in Patients with Liver Cirrhosis 　　LU Guixiang 　　Department of Laboratory,Beihai Municipal Second Peoples Hospital,Beihai 536000,China 　　 　　[Abstract] Objective To investigate the relationship betweenthe Changes in serum sex hormone level and liver cirrhosis. MethodsThe serum sex hormone level was measured by radioimmunoassay in 80 cases of liver cirrhosis and 20 normal subjects. The 80 cases of liver cirrhosis were divided into A-,B- and C-level groups based on Child-pugh classification and the comparison was made between the groups. ResultsThe levels of T and E2 in the liver cirrhosis groups(A-,B- and C-level groups)were lower than the normal control group(P0.01)and the levels of FSH,LH andPRL were higher than the normal control group(P0.01). The Child-pugh classification was negatively correlated with T and E2 levels(r=- 0.55,r=-0.49,P0.05) and was positively correlated with the PRL,LH and FSH levels(r=0.43,r=0.47,r=0.46,P0.05). ConclusionThere are different levels of sex hormone disorder in liver cirrhosis,and the determination of changes in the sex hormone level can be used as an indicator of the clinical prognosis 　　[Key words]Liver cirrhosis; Sex hormone/testosterone; Estradiol; Prolactin 　　 　　肝脏是性激素代谢、降解、生物转化的主要场所,肝硬化不同时期均有不同程度的性激素变化[1],但发生的机制不完全清楚。为进一步阐明肝硬化严重程度与性激素的关系,我们对80例男性肝硬化患者和30例健康男性进行血清性激素测定,现将结果报道如下。 　　1 资料与方法 　　1.1 研究对象 　　收集2005年8月～2008年5月我院男性肝病患者80例,年龄20～70岁,平均51岁,全部病例根据病史、体征、生化、影像学检查确诊为肝硬化,均无心、肺、肾疾病,所有患者均未服用可能影响性激素的药物。其中乙肝肝硬化57例,酒精性肝硬化10例,混合性肝硬化(乙肝+酒精性肝硬化)5例,丙肝肝硬化5例,药物性肝硬