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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (4) : 535 -538. doi: 10.3877/cma.j.issn.1673-5250.2015.04.021

所属专题: 文献

综述

促性腺激素释放激素脉冲治疗的研究进展
符梅   
  1. 611137 成都中医药大学第二临床医学院
  • 收稿日期:2015-04-13 修回日期:2015-07-05 出版日期:2015-08-01

Research progress of pulsatile gonadotrophin releasing hormone therapy

Mei Fu   

  1. Department of Obstetrics and Gynecology, Second Clinical Medical College of Chengdu University of Traditional Chinese Medicine, Chengdu 611137, Sichuan Province, China
  • Received:2015-04-13 Revised:2015-07-05 Published:2015-08-01
引用本文:

符梅. 促性腺激素释放激素脉冲治疗的研究进展[J]. 中华妇幼临床医学杂志(电子版), 2015, 11(4): 535-538.

Mei Fu. Research progress of pulsatile gonadotrophin releasing hormone therapy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(4): 535-538.

促性腺激素释放激素(GnRH)脉冲治疗是通过静脉滴注或者皮下给药的方式连续脉冲式给予GnRH类似物,兴奋垂体产生接近生理性的促性腺激素脉冲,进一步促进性腺发育,合成性激素并维持生殖细胞发育及成熟。GnRH脉冲治疗尤其适用于下丘脑病变,且垂体功能正常而导致的低促性腺激素型性腺功能减退症(IHH)患者,GnRH脉冲治疗方案最接近下丘脑-垂体-性腺轴的生理调节机制,可以模拟正常的生理模式产生内源性的正、负反馈调节。GnRH脉冲治疗是治疗不孕不育的满意方法,也是目前学者研究的热点。笔者拟就GnRH脉冲分泌的特点,GnRH脉冲治疗的应用、治疗剂量和频率、影响因素、优点及缺点进行综述如下。

Pulsatile gonadotrophin releasing hormone (GnRH) therapy is to stimulate pituitary gland to produce physiological gonadotropin by ntravenous or subcutaneous infusion which giving GnRH analogue in pulsation. Sequentially, gonadotropin could promote development of gonad, compound sex hormone, make reproductive cell growth and mature. Pulsatile GnRH therapy is particularly appropriate for patients with idiopathic hypogonadotropic hypogonadism (IHH) whose lesion is located hypothalamus with normal pituitary function. Pulsatile GnRH therapy could produce physiological positive and negative regulation, which are adjacent to physiological regulation mechanism in hypothalamic-pituitary-gonadal axis. Pulsatile GnRH therapy is a good way to treat infertility, becoming a research focus. This article reviews literatures on the characteristics, clinical applications, therapeutic dosage and frequency, influence factors, advantages and disadvantages of pulsatile GnRH therapy.

[1]
Fraietta R, Zylberstejn DS, Esteves SC. Hypogonadotropic hypogonadism revisited[J]. Clinics (Sao Paulo), 2013, 68(Suppl 1): 81–88.
[2]
Pitteloud N, Dwyer A. Hormonal control of spermatogenesis in men: therapeutic aspects in hypogonadotropic hypogonadism[J]. Ann Endocrinol (Paris), 2014, 75(2): 98–100.
[3]
Collins JS, Marshall JC, McCartney CR. Differential sleep-wake sensitivity of gonadotropin-releasing hormone secretion to progesterone inhibition in early pubertal girls[J]. Neuroendocrinology, 2012, 96(3): 222–227.
[4]
都春风,杨国庆,母义明,等.男性特发性低促性腺激素型性腺功能减退症87例临床分析[J]. 中国实用内科杂志2007, 27(23): 1839–1841.
[5]
Delemarre-van de Waal HA. Application of gonadotropin releasing hormone in hypogonadotropic hypogonadism--diagnostic and therapeutic aspects[J]. Eur J Endocrinol, 2004, 151(Suppl 3): U89–U94.
[6]
孙首悦,王卫庆,蒋怡然,等.微量泵脉冲输注戈那瑞林治疗特发性低促性腺激素性性腺功能减退症[J].中华内分泌代谢杂志2011, 27(8):654–658.
[7]
Pitteloud N, Hayes FJ, Dwyer A, et al. Predictors of outcome of long-term GnRH therapy in men with idiopathic hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 2002, 87(9): 4128–4136.
[8]
Christin-Maitre S, De Crécy M, Groupe Français des pompes à GnRH. Pregnancy outcomes following pulsatile GnRH treatment: results of a large multicenter retrospective study[J]. J Gynecol Obstet Biol Reprod (Paris), 2007, 36(1): 8–12.
[9]
Abel BS, Shaw ND, Brown JM, et al. Responsiveness to a physiological regimen of GnRH therapy and relation to genotype in women with isolated hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 2013, 98(2): E206–E216.
[10]
Gronier H, Peigné M, Catteau-Jonard S, et al. Ovulation induction by pulsatile GnRH therapy in 2014: literature review and synthesis of current practice[J]. Gynecol Obstet Fertil, 2014, 42(10): 732–740.
[11]
孙首悦,贾慧英,朱巍,等.促性腺激素释放激素皮下微量脉冲输注治疗中枢性继发性闭经一例临床研究[J].中华内分泌杂志201430(3): 197–200.
[12]
Graña-Barcia M, Liz-Lestón J, Lado-Abeal J. Subcutaneous administration of pulsatile gonadotropin-releasing hormone decreases serum follicle-stimulating hormone and luteinizing hormone levels in women with polycystic ovary syndrome: a preliminary study[J]. Fertil Steril, 2005, 83(5): 1466–1472.
[13]
Gill S, Taylor AE, Martin KA, et al. Specific factors predict the response to pulsatile gonadotropin-releasing hormone therapy in polycystic ovarian syndrome[J]. J Clin Endocrinol Metab, 2001, 86(6): 2428–2436.
[14]
Dubourdieu S, Fréour T, Dessolle L, et al. Prospective, randomized comparison between pulsatile GnRH therapy and combined gonadotropin (FSH+LH) treatment for ovulation induction in women with hypothalamic amenorrhea and underlying polycystic ovary syndrome[J].Eur J Obstet Gynecol Reprod Biol, 2013, 168(1): 45–48.
[15]
Bayram N, van Wely M, van der Veen F. Pulsatile gonadotrophin releasing hormone for ovulation induction in subfertility associated with polycystic ovary syndrome[J]. Cochrane Database Syst Rev, 2004, 1: CD000412.
[16]
李卓莉,郝敏,赵卫红.腹腔镜手术联合促性腺激素释放激素激动剂治疗深部浸润型子宫内膜异位症的临床疗效分析[J/CD].中华妇幼临床医学杂志:电子版201410(2): 189–198.
[17]
Hughes VA, Boepple PA, Crowley WF Jr, et al. Interplay between dose and frequency of GnRH administration in determining pituitary gonadotropin responsiveness[J]. Neuroendocrinology, 2008, 87(3): 142–150.
[18]
Martin KA, Santoro N, Hall JE, et al. Management of ovulatory disorders with pulsatile gonadotropin-releasing hormone[J]. Clin Endocrinol Metab, 1990, 71(5): 1081A–1081G.
[19]
Seminara SB, Beranova M, Oliveira LM, et al. Successful use of pulsatile gonadotropin-releasing hormone (GnRH) for ovulation induction and pregnancy in a patient with GnRH receptor mutations[J]. J Clin Endocrinol Metab, 2000, 85(2): 556–562.
[20]
King TF, Hayes FJ. Long-term outcome of idiopathic hypogonadotropic hypogonadism[J]. Curr Opin Endocrinol Diabetes Obes, 2012, 19(3): 204–210.
[21]
Mao JF, Xu HL, Duan J, et al. Reversal of idiopathic hypogonadotropic hypogonadism: a cohort study in Chinese patients[J]. Asian J Androl, 2015, 17(3): 497–502.
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