<link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/css/video-js.min.css?v=1"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/base.css?v=5"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/index.css?v=35"><link rel="stylesheet" href="https://ysz-web.yxj.org.cn/live/dist/static/base/index.css?ysz_v=2.0"><script src="https://studioyszimg.yxj.org.cn/js/dsbridge.js?v=13" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/dsBridge/main.js?v=26" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/base/fun.js?ysz_v=3" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/js/nativeToWeb.js?v=1" type="text/javascript"></script><div id="ysz-header" style="margin:0;overflow:hidden;"><h1 style="font-size:24px;line-height:1.8;color:#333333;word-wrap:break-word;">代谢内分泌科来了个「闭经」的女性,难道真相只有这么简单?</h1><h2 style="font-size:16px;color:#999999;word-wrap:break-word;"><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">2022-05-17</em><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">博文</em><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">原创:医学界内分泌频道</em></h2></div><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">病例速递</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">患者女,18岁,未婚。</span></strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">主诉:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">月经一直未来潮,发现泌乳素升高1年余。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">现病史:</span></strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">患者自诉<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">约12岁时开始出现第二性征(乳房开始发育,阴毛、腋毛相继出现)</strong>,但月经一直未来潮,且身高于12岁后未再增长。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">2019年08月(16岁)因月经未来潮、身高未再增长,患者就诊于东莞市人民医院,当时无溢乳,无头痛,无视力下降、视野缺损,无痤疮等,自诉查性激素六项提示PRL明显增高,垂体MRI提示泌乳素瘤(未见化验单及检查报告),<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">考虑泌乳素瘤,予以“溴隐亭5 mg每天1次”治疗</strong>,于2020年3月份出现1次少量阴道流血(表现为仅内裤上可见红色血迹),后未再出现阴道流血,患者仍规律服药,服药期间曾多次复查PRL仍明显偏高(具体不详),但未调整治疗方案。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">2021年1月24日患者自行停药,并于2021年1月31日就诊于武冈市人民医院,查性激素六项:睾酮42.12 ng/dL(参考范围女性卵泡期9.01-47.94 ng/dL),孕酮2.05 ng/mL(参考范围女性卵泡期0-1.4 ng/mL),FSH 3.97 nIU/ml(参考范围女性卵泡期2.5-10.2 nIU/ml),LH 2.36 mIU/L(参考范围女性卵泡期1.9-12.5 mIU/L)PRL>4240 uIU/mL(参考范围59-619 uIU/mL),雌二醇30.22 pg/mL(参考范围女性卵泡期19.5-144.2 pg/mL);垂体核磁提示垂体右侧下缘膨隆,意义待定,蝶窦及额窦炎。子宫附件彩超提示:子宫测值偏小,双侧卵巢多发囊性暗区。建议上级医院就诊。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">患者遂来我院我科门诊,以“闭经查因”收入院。起病以来,无畏寒乏力,无皮肤色素沉着,无头痛头晕,近一年精神、食欲、睡眠可,大便干结,小便正常,体重无明显改变。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">既往史:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">无特殊。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">个人史:从小与同龄人相比身高偏矮,</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">其余无特殊。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">月经史:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">月经未来潮。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">婚姻生育史:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">未婚未育。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">家族史:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">父母健在,母亲身高163 cm,父亲身高175 cm,兄弟姐妹健在,姐姐身高160 cm,弟弟身高176 cm,否认家族性遗传病史。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">入院查体:</span></strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">体温:36.8℃,脉搏:78次/分,呼吸:20次/分,血压:99/66 mmHg,身高150 cm,遗传身高162.5±8 cm,体重50 Kg,BMI 22.2 Kg/m<sup>2</sup>,上部量74 cm,下部量76 cm,指间距147 cm。其余查体未见明显异常。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">专科检查:</span></strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">专科检查:</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">无痤疮,皮肤粘膜无色素沉着,颈后发际线无后移,未触及喉结;上唇见小须;双乳晕颜色淡,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">乳房Tanner III期,双侧腋下有腋毛生长;</strong>腹中线少许毛发;<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">阴毛Tanner V期,</strong>阴蒂、小阴唇、大阴唇外观未配合检查。粗测视野未见异常。</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">辅助检查:</span></strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">血常规、大便常规未见异常;尿常规:白细胞酯酶2+,镜检白细胞0-3;尿沉渣:尿白细胞酯酶2+,白细胞总数24.70/uL,细菌信息未提示,白细胞(人工)2-5个/HP;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">肝功能:总蛋白63.7 g/l↓,白蛋白38.6 g/l↓;肾功能:尿酸391.1 μmol/l↑,余无异常;心肌酶无异常;血脂无异常;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">空腹血糖4.68 mmol/l,120分钟血糖6.10 mmol/l,胰岛素释放实验(0分钟)5.2 mu/L,胰岛素释放实验(120分钟)>300.00 mu/L↑;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">25-羟基维生素D 34nmol/L;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">床旁心电图、胸片、心脏和腹部彩超正常。</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">泌乳素>200.00 <strong style="font-size: 16px; text-align: justify; white-space: normal; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">μ</strong>g/L;泌乳素普通检测稀释试验(稀释10倍)后换算浓度为501 μg/L;聚乙二醇沉淀法326.4 <strong style="font-size: 16px; text-align: justify; white-space: normal; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">μ</strong>g/L;</strong></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">GH 2.32 μg/L;甲状旁腺素、胰岛素样生长因子-1、胰岛素样生长因子结合蛋白-3未见异常;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">子宫附件彩超:经腹超声:<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">子宫前位,大小约28×23×15 mm,</strong>实质回声均匀,内膜线居中,厚约2.8 mm,宫内及肌壁未见明显肿块声像。左侧卵巢大小约21×14 mm,右侧卵巢大小约30×16 mm,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">双侧卵巢内可见多个2-9 mm小囊性暗区</strong>(右侧约10个,左侧约8个),边界清,内透声可,较大者约7×6 mm(左)、7×6 mm(右)。CDFI:子宫及双侧卵巢未见明显异常血彩及频谱。结论:子宫测值偏小;</span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">脑部MRI检查:鞍区和右侧鞍旁11.6x8.5mm,轻度包绕境颈内动脉,增强明显强化,垂体柄未见偏移,视交叉无明显上抬;</span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED3049AA30CDF2DF84D00.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">图1</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">骨龄测定:17.5-18岁。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED3049F76F50D67BD6D5F.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">图2</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><br/></section></section></section></section></section></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">综合上述患者的病史及实验室检查后,我们总结了患者有以下特点:18岁青年女性,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">闭经表现,暂考虑原发性闭经;性发育滞后,催乳素水平增高,彩超:子宫偏小;骨龄测定稍低,存在维生素D缺乏的可能;头颅MR示瘤样改变,合并鞍区和蝶窦改变;且临床使用溴隐亭疗效不佳。</strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;"><br/></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">抽丝剥茧,真相逐渐浮出水面</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">但患者是以“闭经查因”收住入院,我们首先得找寻一下患者闭经的病因。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">闭经在临床上又分为原发性闭经和继发性闭经。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">原发性闭经:</strong><span style="font-size: 16px; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"></span></span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">年龄&gt;14岁,第二性征未发育</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">年龄&gt;16岁,第二性征已发育,月经还未来潮</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;"></span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">继发性闭经:</strong><span style="font-size: 16px; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"></span></span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">已有规律月经来潮,月经停止6个月以上,或自身原有月经周期停止3个周期以上</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">基于此我们可以看出,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">该名患者属于原发性闭经中的第二种。</strong>根据《闭经诊断与治疗指南(试行)》提出的原发性闭经诊断流程(图3),我们应对患者进行妇科检查及盆腔B超检查,查看患者是否存在子宫或子宫内膜的情况。</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED304A28F957C273D0A88.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">图3</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">但结合患者此前在外院所做的相关检查,虽子宫测值偏小,但并未存在明显的缺如或伴其他畸形等,生殖道也没有明显的阻塞,因此暂时考虑该患者可能存在垂体或先天性发育缺陷或遗传异常引起。故我们改变了思考方向,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">下一步给患者进行血FSH和LH水平测试[促性腺激素释放激素(GnRH)]。</strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED304A4224FA413C267BA.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">图4</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">GnRH兴奋试验正常,LH和FSH 30-60min内达峰,提示性腺轴反应正常,但基础水平LH<15,<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">考虑为高泌乳素抑制GnRH,引起性腺功能减退,提示患者可能存在下丘脑垂体性闭经。</strong></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">而对于下丘脑垂体性闭经,临床上一般考虑肿瘤相关的比较多,常见于以下几种:</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">表1</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED304A58DD3AC1344A5F4.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">结合患者出现的各项症状及检查结果来看,考虑患者泌乳素瘤可能性较大,</span></strong><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; overflow-wrap: break-word !important; box-sizing: border-box !important;">遂立即完善相关辅助检查:</span></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; color: rgb(136, 136, 136); font-size: 14px; overflow-wrap: break-word !important; box-sizing: border-box !important;">表2</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED304A7DEED343341B989.jpg" style="margin: 0px; padding: 0px; vertical-align: bottom; overflow-wrap: break-word ;"/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">性腺轴:性激素结合球蛋白、β-人绒毛膜促性腺激素<0.100 mIU/ml、抗缪勒氏管激素(AMH)均无异常;硫酸脱氢表雄酮5.94 mg/L;性激素:促黄体生成激素5.69 Iu/l,促卵泡成熟激素6.04 Iu/l,雌二醇0.10 nmol/L,睾酮1.27 nmol/L,孕酮0.87 ug/L。</span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">至此,患者目前所有的入院查体和辅助检查结果已出,我们的诊断也就明确了:</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">垂体泌乳素瘤</strong><span style="font-size: 16px; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">(但患者身高低于遗传身高,可能还合并部分性生长激素瘤)</span></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">维生素D缺乏</strong></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">甲状腺囊肿,TI-RADS 2类</strong></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">尿路感染</strong><span style="font-size: 16px; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"></span></span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;"><br/></span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">谜底已揭,探“泌”成功</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">针对患者的上述诊断,我们做了如下对症治疗:</span></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><ul class=" list-paddingleft-2"><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">溴隐亭每次2.5 mg每天2次(根据泌乳素水平调整剂量,每10天可增加2.5 mg)</strong></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">维生素D滴剂每次800IU每天1次</strong></span></section></li><li><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="font-size: 16px;"><strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">定期复查PRL,每年复查头颅MRI</strong><span style="font-size: 16px; margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"></span></span></section></li></ul><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><p style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;">在后期我们对患者进行了随访,在患者出院2周后再次复查泌乳素79.4 ug/L,但在服用溴隐亭后患者出现头痛,故调整为卡麦角林,1周1次1次0.5 mg;<strong style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;">在调整药物2月后开始出现月经,大约每月1次,每次4-5天,</strong>月经量偏少。后续我们还将持续观察患者的药物反应及症状变化。</span></p><p style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="margin: 0px; padding: 0px; max-width: 100%; color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; overflow-wrap: break-word !important; box-sizing: border-box !important;"><br/></span></p><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><p style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span style="color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; text-align: justify;">戳下方链接,可直接观看文章课程视频!</span><span style="color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; text-align: justify;">还有更多湘雅探“泌”系列课程等你来看!</span><span style="color: rgb(0, 0, 0); font-family: &quot;Helvetica Neue&quot;, Helvetica, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; font-size: 16px; text-align: justify;"><span class="appskip" data-appskip="yxjysz" data-appskipobj="{&quot;type&quot;:18,&quot;id&quot;:0,&quot;title&quot;:&quot;&quot;,&quot;url&quot;:&quot;https://yxj2.cn/UAuzeR&quot;}">https://yxj2.cn/UAuzeR</span></span></p></section><section style="margin: 0px; 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line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;"><br/></span></p><p style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">专家简介</span></p></section><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; overflow-wrap: break-word !important; box-sizing: border-box !important; text-align: justify; line-height: 1.75em;"><br/></section><section style="margin: 0px; padding: 0px; max-width: 100%; text-align: center; line-height: 1.75em; overflow-wrap: break-word !important; box-sizing: border-box !important;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://studioyszimg.yxj.org.cn/AC14B0B6017ED304A9E1B204309D65A7.jpg" style="margin: 0px; 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