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目的:分析原发性闭经(PA)中特发性低促性腺激素性腺功能减退症(IHH)的临床特征,总结治疗方法及效果。方法:回顾性分析15例IHH患者的临床特征,并与15例月经规律正常的不孕妇女进行对照,比较血FSH、LH、E2、PRL、T水平。对15例IHH患者进行人工周期和尿促性腺激素(HMG)促排卵治疗,比较治疗3个周期前后血清性激素水平、子宫和卵巢的变化。结果:IHH患者内外生殖器官幼稚,第二性征不发育,细胞遗传学检查其染色体核型均为46,XX。血FSH、LH和PRL水平明显低于正常妇女(P<0.001),血E2和T水平与对照组相比无明显差异(P>0.05)。人工周期治疗后血FSH等5种激素水平均较治疗前明显升高(P<0.01),子宫、卵巢体积较前显著增大,有12例临床妊娠。结论:人工周期治疗后予HMG促排卵治疗是对有生育要求的低促性腺激素性闭经患者的有效治疗方法。
Objective: To analyze the clinical features of idiopathic hypogonadotropic hypogonadism (IHH) in primary amenorrhea (PA) and to summarize the treatment methods and effects. Methods: The clinical features of 15 patients with IHH were retrospectively analyzed. The levels of serum FSH, LH, E2, PRL and T were compared with 15 normal infertile women with normal menstruation. 15 cases of IHH patients with artificial cycle and urinary gonadotropin (HMG) ovulation induction treatment, the treatment of three cycles before and after serum sex hormone levels, uterine and ovarian changes. Results: The IHH patients had immature reproductive organs inside and outside, and the secondary sexual characteristics were not well developed. The cytogenetics of IHH patients were 46 and XX. The levels of FSH, LH and PRL in serum were significantly lower than those in normal women (P <0.001). The levels of E2 and T in serum had no significant difference compared with those in control group (P> 0.05). Blood levels of FSH and other 5 hormones were significantly increased after treatment (P <0.01), and the volume of uterus and ovary significantly increased compared with that before treatment. There were 12 clinical pregnancies. CONCLUSION: Ovulation induction by HMG after artificial cycle therapy is an effective treatment for patients with hypogonadotropic amenorrhea who have fertility requirements.