所謂出血性メトロパチーに於ける下垂体前葉のGonadotropin分泌機能に関する研究

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The so-called Metropathia haemorrhagica characterized by the excessive secretion of estrogen without ovulation is one of the most significant endocrinological disturbances in the gynecological field. The author has made, besides the clinical observation in detail, the systemic estimation of gonadotropin in urine of the patients in order to investigate the gonadotropin secretory function of the anterior pituitary. The data were studied comparing with those obtained from the normal non-pregnant women of corresponding ages. The gonadotropin content in urine was very low by the adolescent normal women, and increased pararelly with the age, and the gonadotropin excretion in urine showed, throughout the sexually matured period, the marked increase at the ovulatory period and made one of the evident peaks, but there were no differences between the follicle-, and corpus luteum phase. In the patients of Metropathia haemorrhagica the author found the excessive gonadotropin excretion in urine before the beginning of bleeding and this exceeded that of normal matured woman at the ovulatory period. Moreover this high content of gonadotropin in urine was chiefly due to the increase of GA, and GB was rather low. This data suggests the disturbances of balances between FSH and LH secretion of anterior pituitary before the beginning of bleeding. Both fractions of gonadotropin in urine decreased as the bleeding began. The findings above suggest that the bleeding of Metropathia haemorrhagica is caused by the ovulatory disturbances due to the unbalances between FSH and LH secretion. Then author attempted to normalize the sexual cycle by adjusting the unbalances of gonadotropin secretion by means of administration of large dosis of PMSG with strong FSH activity, and of HCG with LH activity. As the result, in many cases the ovulatory cycle was brought about, as the author has anticipated. Moreover, no irregular bleeding was observed in the successful cases for a long period. The gonadotropin secretory function was then examined by the administration of various sex steroids. After the administration of estrogen the gonadotropin, especially GB, was found to increase in urine. This suggests that the estrogen meets anyhow the therapeutic purposes to adjust the un-balance of GA and GB, and to normalize the ovulatory sexual cycle. The administration of either progesterone or androgen gave no desirable results, as either of them inhibited the gonadotropin secretion only temporalily. The histochemical studies on the hypophysis of rats in persistent estrus gave the findings that suggested the ovulatory disturbances and acceleration of FSH secretion, and showed us that it could be collated to the Metropathia haemorrhagica. The administration of these three steroids on the rats in persistent estrus was found to inhibit the FSH secretion once accelerated. From the fact mentioned above the author reached to the conclusion that the Metropathia haemorrhagica was caused by the ovulatory disturbances due to the unbalance of FSH and LH secretion, and proved that simultaneous administration of large dosis of PMSG and HCG was therapeutically excellent for the adjustment of the balances of FSH and LH for the establishment of normal ovulatory cycle.
日本内分泌学会の論文

所謂出血性メトロパチーに於ける下垂体前葉のGonadotropin分泌機能に関する研究

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