克罗米酚对男性低促性腺素性功能减退症必需

纽约（费希尔社健康版）1年底四日路透社：据发表在12年底出版的《生育与不育》杂志的一项报告说明克罗米酯类对外极低促性腺可抑制性功能有所改善的年长者患儿十分困难。来自阿伯丁阿拉巴马学院的该报告的第一笔记Scott J. WhittenClark在接受费希尔通讯社谈话时说：“上皮细胞或获得性HH患儿在接受扰乱性相当大和极为昂贵的疗法（例如注射促性腺激可抑制类）前透过4个年底的克罗米酯类试验性疗法是十分困难的。”WhittenClark和同事研究者了克罗米酯类对10名HH年长者患儿（HH是致使年长者不育的常见因可抑制）确实有效。报告称克罗米酯类疗法1年后，4名卡尔曼(氏)性疾病患儿里面只有一名患儿的体内浓度增加而全垂体功能有所改善症患儿的体内缺乏症状原则上没有得到改善。相反，该报告说明3名成年人发病的上皮细胞HH年长者患儿经过3个年底克罗米酯类的疗法体内浓度有了明显增加。目前为止该组患儿仅有两名丧失了后生。WhittenClark说：“除非对克罗米酯类疗法没有反应，我们不会因为病症停止对患儿采用该制剂。”最终笔记总结说：“因为条件极小，对HH患儿促性腺激可抑制类制剂和克罗米酯类的随机研究者很难透过，然而利用多系列的严苛选择标准对患儿透过分级意味著为了让进一步验证克罗米酯类丧失年长者极低后生的理论上。 Male Hypogonadotropic Hypogonadism May Respond to Clomiphene CitrateBy Will Boggs, MDNEW YORK (Reuters Health) Jan 04 - Some men with hypogonadotropic hypogonadism (HH) benefit from treatment with clomiphene citrate, according to a report in the December issue of Fertility and Sterility.Patients with idiopathic or acquired HH "may benefit from a 4-month trial (of clomiphene citrate) before proceeding with more invasive and expensive therapies, such as injectable gonadotropins," lead author Dr. Scott J. Whitten, from University of Alabama at Birmingham, told Reuters Health.Dr. Whitten and colleagues investigated whether 10 men with HH, a rare cause of male infertility, might respond to treatment with clomiphene citrate.Only one of four patients with Kallmann's syndrome experienced an improvement in sperm concentration after 1 year of therapy with clomiphene citrate, the authors report, and no patient with panhypopituitarism experienced a reversal of azoospermia with clomiphene citrate treatment.In contrast, all three men with -onset idiopathic HH experienced significant increases in sperm concentrations and testosterone levels after 3 months of therapy with clomiphene citrate, the report indicates. Two pregnancies he been achieved in this subgroup so far."We did not he any of our patients discontinue the clomiphene because of side effects, only if there was lack of response," Dr. Whitten said."Because this is such a rare condition, additional randomized studies comparing gonadotropins with clomiphene in this subtype of HH patients would be difficult to perform," the authors conclude. "However, larger series using strict inclusion criteria for stratifying patients may be helpful to further examine the success of clomiphene treatment in restoration of this form of male subfertility."Fertil Steril 2006;86:1664-1668.

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总编辑： 张靖