( 20 010010) 787 1092 1/32 498.50 4 980 2004 9 1 2004 9 1 1 1 000 ISBN 7-204-05940-9/R 019 1880.00 ( 20.00 )
...1...1...3...4...6...8...8...9...10... 11...12...13...14...15...17...18...20...21...22 I
...23...24...25...26...26...27...29...30...31...32...34...34...36...37...37...38...40...40...42...43...44...45 II
...46...48...49...49...50...52...53...53...55...56...58...59...60...61...63...65...66...68 B...69...70...71...72 III
...74...75...76...78...80...81...81...82...84...85...86...86...88...89...90...92...93...94...95...96...97...98 IV
...99... 101... 102... 103... 104... 105... 106... 107... 109... 110... 113... 114... 115... 116... 117... 118... 119... 121... 122... 123... 124 V
... 125... 126... 127... 129... 130... 131... 133... 135... 136... 137... 138... 140... 141... 142... 144... 146... 146... 147... 149... 149... 151... 152 VI
... 153... 155... 156... 157... 159... 161... 163... 164... 166... 167... 168... 170... 170... 172... 174... 175... 176... 176... 177... 178... 180 VII
... 181... 183... 184... 186... 187... 188... 188... 189... 191... 192... 193... 194 VIII
1 3 1% 1
2
T ( ) 3
4
5 1000 8 87% ( ) 3% 4 ( )
6 1 1.75% 1/4
7
8 0 0.84nmol/L 3 0.84nmol/L CT 4% (Peyronie's disease) 1743 1
9 E 3cm 0.2cm
10 2 7 2 3 5
11 3
( ) 10 20 1 50 60 70 20 50 12
13 25% (1)
14 (2) (3) 5 (4)
15
16 50%
17 2 6
18 80% 2 1
19
20 3 4ml
21 90% 10%
22 20% 48 37 11 70%
23 63.3% ( )
24 B CT 10
25
1 2 3 2 2 24 1 3 5 2 3 40 1 2 1 2 3 2 2 24 1 26
3 5 2 3 40 1 2 (1) (2) 27
(3) (4) (5) (6) (7) (8) 28
52 700 7 16 37% 27% E B A 29
30 E C
31
32 Young 1975 Pederson Afzelius Eliasson 50% Young
3.3% 21% 67% 50%Young 1 1.5cm 62% X 41% FSH LH 1 1500 1 2000 33
34 (WHO) Rowe Farley1988 6407 2.9% 2.7% 4.0% 1957
35 50 70
36
X r 200 300 X 600 800 ( 0.3 ) 37
38 (FSH)
39
40 RNA B CT (kg) (cm)-100 10
41 20
4 1976 1983 11 50 4 20 42
43 1964 1979
44 1990 70 60% 70% 80% 50% 70%
90% 10 3 10 90 2 8 8 45
2 10 4 4 10 20 10 20 19 22 46
3 8 1% 20% 16% 18% 40% 16 1987 1490 1988 2904 1989 8321 136.32% 1966 1981 46% 1980 1986 150% 65% 47
48 (AIDS) 80% 3 93% 7% 4 5 7 9 1
49
( ) ( ) 1 13 15 11 12 17 18 10 18 50
1 1 28 7 1 2 3 5 2 7 1 1 50 60ml 20 100ml 51
52 1 (1) (2) ph
53 ( )
54 (1) (2) 3 8 (3) 1 2 (4)B (5) (6) (7)
(8) (FSH) (LH) (PRL) (P) 12 55
56 (Noyes) 2 ( BTT) (6 8 )
0.3 0.5 1 2 5 ( ) 3 ) ( 57
2 3 11 0.3 ( ) (1) 10cm 1 2cm 2 3 48 72 58
59 (2) ( ) 1cm (3) 7
60 22 ( ) 24
61 2 3 1 (1) 60ml 2.7kpa (2) 12mg 20ml( 200ml) 10 30
62 90% 60% 80% 50% (3) 0.25% 20ml ( 5ml) 20ml 5 10ml 10ml 3 (4) X (5)
(6) B 3ml 0.6 1.0cm 3% 6 10ml ( ) 3 63
3 8 2 64
65 6 ( ) 100 70
5 1 2 1 2 7 ( ) 24 18 66
67 75% (25%) 50%
B 2 4 1mg 21 3 8 ( ) 21 4 20mg 3 8 ( ) 68
B B B B 8 B 18mm 21 22mm 3 10mm B 3% 69
B 46 44 23 22 1 xx xy ( ) 18 47 xxx 70
71 1 12 X X
72 X X
3 5 ( ) 1 2 ( 15 16 ) 20 2 3 5 ( 1cm) 10 5 1 2 73
74 ( ) (LH)/ (FSH) 3
16mmol/L(5mg/L) 624mmol/24h(2mg/24 ) 25% 30% 75
8 2 3 B (1) 10% 20% B 6% 76
1 48.28% 1 2 1 2 5 (2) (Insler) 1 2 4 5 8 (3)B 8 B 1 6 6 8 (4) 8 9 ( 24 ) (5) (LH) 26 27 10 28 29 77
11 31 32 12 32 33 13 5 6 (1) (FSH) FSH 1.5 10mIU/ml 8 20mIU/ml 2 10mIU/ml 5 40mIU/ml FSH FSH FSH 40mIU/ml (2) (LH) (FSH ) LH 2 15mIU/ml 30 100mIU/ml 4 10mIU/ml 5 25mIU/ml 5mIU/ml FSH 78
LH LH/FSH (PRL) 3 PRL 0.08 0.92nmol/L 1.0nmol/L FSH LH (E2) E2 48 521 / 70 1835 / 272 793 / E2 (P) P 0 4.8nmol/L 7.6 97.6nmol/L P (T) 50% 79
25% 25% T 0.7 3.1nmol/L T T ( ) ( ) 20mg 4 3 8 4mg 3 5 10mg 6 80
( ) (HMG) HMG150u 4 6 B B HMG ( ) 81
(LH RH)25 100mg 15 30 60 120 (LH) LH RH LH ( ) LH Combes LHRH100mg 4 30 45 LH 60 90 2 4 LH 2 LHRH 2 LH LH ( ) 100mg 1 5 3 5 5 FSH LH 82
FSH LH 3 10 FSH LH (1) (2) (3) (4) ( ) 83
(1) 0.4 0.6 (2) (3) (4) 84
(1)FSH LH PRL PRL 0 20 g/l PRL 25 g/l PRL X CT FSH 5 20u/L LH 5 25u/L FSH 40u/L LH 25u/L FSH LH 5u/L (2) Combes (3) X X CT CT (1cm) (4) 85
T3 T4 TSH 17 17 8 2 3 B (1) 86
87 (2) 10 30 ph (3) CT (4) ( )
5 7 1 2 3 1 2 (20 ) 37 88
1 600 /ml 50% 6 20% 3cm 30% 600 1500 /ml 50% 70% 8 20% 3 5cm 1 ph 89
8.9 7.0 8ml 1ml 3 0 2 1 2 1 0 2 (1) 90
91 (2) (3) ( ) (4) (5) (6) ( )
92 (7) ( ) ( ) ( 7 10cm 1 ) ( 198ml 12ml )
93 (1) (2) 14% 100% 10% (3) (4)
10 (5) (6) (1)X CT X X X 94
CT MRI CT (2) (3) (4) (5) (6) 1883 1928 1956 95
46 46 23 X X Y 2% 21% 1.5 2ml (5ml) 0.2 0.3ml 37 72 3 4 ( ) 002 g/ml ( ) X 96
704 49 696% 49 7 42 2 92% 1 12.1% 21.1% 2 50% 12ml 97
(Klinefelter) X 47 XXY 46 XX/47 XXY 10% XYY 47 XXY 1/750 46 XX 98
(GAT) (TAT) 1 (TSAT) GAT 20 TAT 1 32 TSAT 12 10% 100 8 (SIT) (SIV) 2 (MAR) (IBB) (ELISA) (RIBA) 99
X 35 37 1.2 1.5ml 15 (1) 256 104mg/dl 882 (2) 412 /ml (3) Furthherrmann 56 2.0mg/dl 0.8g/dl (4) 3.6 100
(5) 130 56 g/ml 1.85 0.15 g/ml 0.81 004 g/ml (6) X(LDHX) LDH 101
102 (cm 3 ) (cm) (cm) (cm) /6 1 25 ( )
(25 ) 19 23 13.1 3.6cm 13.6 4.2cm 24 45 13.6 4.2cm 14.4 4.5cm( ) 103
T 0 T 1 ( ) T 2 ( ) T T 1 +T 2 (Amin) (Amax) 32 T1 4 18 10 T2 5 50 10 T 10 08 10 Amin 0.02 0.001 Amax 3.0 0.2 93mm 0.725mm 0.625mm 0.5ml 1mm 0.5ml 104
0.725 48 75 94 223 2 25 30 30 30 60 24 FSH 105
(1) 1 2cm 0.5cm 106
107 4 (2) (3) 1 2%1% 10ml 0.7cm ( ) 0.5cm 0.5 0.7cm (1)
108 ( ) (2) (3) (4) (5) (6) (7)
(8) (FSH) (ICSH) (PRL) (T) 1 4 5ml 4 (1)4 FSH 0.9 9.8 /ml ICSH 1.1 8.2mIU/ml PRL 0 0.84 /T 9.0 45.8 / (2) 4 FSH FSH 109
FSH FSH ICSH FSH ICSH ( ) HCG FSH ICSH T PRL FSH ICSH ( 1cm) CT ICSH 1.5 2 1 110
(GnRH) (HCG) (1) ( E2) (GnRH) GnRH GnRH FSH ICSH ICSH FSH ICSH T 3 200mg 10 FSH FSH ICSH T ICSH T ICSH (2) (GnRH) 111
GnRH FSH ICSH GnRH FSH 3 ICSH 3 6 1 15 2 GnRH100mg 20 60 120 3 4 5 FSH ICSH ICSH FSH GnRH ICSH FSH (3) (HCG) ICSH 1 HCG2000IU 4 2 HCG2000 7 3 HCG 3 HCG2000 12 (HCG ) 112
HCG (HCG ) 1 ( ) 4 10 113
1 100 10 40 70 3 80%( 44%) 10% 14% 114
115
(1) 1/3 (2) 116
117 (3) (4) (5) 10 (6)
118 1 1
119
120 2% 4% ( )
121
122 (1) 3 7 1% 2 3 (2)
123 1 2 2 1 2 E
0.5 1mg 7 10 0.25mg 80 3 4 Kirchhoff ( 5 25 )3 4 HMG LH- RH 124
125 B 48 8 9 B
126 70% 32% (HMG) (HCG) (1)
127 0.5mg (2) (3) HMG/HCG (4)
(1) ( ) 5 50 150µγ/ 5 5 11 0.125 0.25µγ/ 20 1 3 0.125 0 25µγ/ 7 (2) 3 (3) (ΗΧΓ) ΗΧΓ ΗΧΓ 50 150µγ/ 5 4 16 Ε 2ε1000ΠµοΛ/ΛΒ 2.0χµ ΗΧΓ5000 10000ιυ α ΗΜΓΗ ΧΓ ΗΜΓ ΦΣΗΛΗ75ιυ 50 150µγ/5 6 ΗΜΓ2 6 8 128
(Ε2)ε1000Πµολ/Λ 2.0χµ (ΗΜΓ) 36 ΗΧΓ5000 10000ιυ (4) (ΛΗ ΡΗ) 90 120 1 5 γ/ 10 20 γ/ 17 20 5 50 γ 7 10 (5) 1.25µγ 2.5µγ 2 2 3 4ΠΡΛ 3 10 20µγΗΧΓ2000ιυ 5 6 (1) 129
130 ( ) 2 3 31 2 3 15% (2) (3) 10% 20% (1)
3 6 (2) 5µγ 3 20% 45% (3) (4) ( ) 83% 33% (5) (ΓΙΦΤ) Νερωε 16 ΓΙΦΤ 7 (43%) 131
(1) (2) α β χ 132
δ (ΓνΡΗα) ε18 (3) (1) Κιστνερ1956 18 0.3µγ 6 12 18 0.6 0.9µγ 0 06 0 09µγ 80% 20% 40% (2) 20 30µγ 6 2 25 0µγ 3 250µγ 3 0.25µγ 0.5µγ (3) 133
400µγ 6 600µγ 800µγ 4 6 2 50% 70% (4) 5µγ/ 3 6 (5) (ΓνΡΗα) ΓνΡ Ηα ΓνΡΗα 200 4 00γ 3 ΓνΡΗα100 γ 6 134
135 4 6 (6)18 ( ) 2 2.5µγ 6 60% (1)
70% α (2) 45 (3) 45 (1) (2) 136
3 7 (1) 25µγ 2 ( 16 17) α 10µγ 20µγ 2 β 2µγ 3 5µγ 2 2 125µγ 2 2 3 2 3 137
14 12 (2) (ΗΧΓ) 3 4 ΗΧ Γ2000 3000υ 3 4 3 1000υ 7 8 (3) 3 50µγ 5 (4) 1 2 2.5µγ 1935 Στειν Λεϖεντηαλ ΣτεινΛεϖεντηαλ 138
139 (1) α 0 05µγ 100µγ 1 3 β 0.75µγ 3 (2) 7 8 1) 2 0.05µγ 1 7 2) Β ΗΧΓ5000 10000υ 3)
0.25 0.5µγ/ α (ΗΜΓ) ΗΜΓ ΗΧΓ β (3) 1/3 ΦΣΗ ΛΗ/ΦΣΗ (ΣτεινΛεϖεντηαλ)436 ( ) 359 2 3 58 95% Γολδζιεηερ 1079 80%(6% 95%) 63%(13% 89%) 53 46(86.8%) 37(69.8%) Στειν 140
141 95% 85% / 1984Γιενναεσσ 62 3 85% 1989 ανιελλ 81 71% ΓνΡΗ ΦΣΗΛΗ
50µγ 5 5 6 10 0.3 0.5 12 12 16 5 3 5 14 10νγ/µλ 50µγ 100µγ 50µγ 200 250µγ 5 16 (ΗΧΓ) (ΕΙΠΤ) 87 64 73.6% 30 142
34.5% 5 10 Σπεροφφ 5 3 4 2 10 16( ) 0.25µγ 4% 9% 15% 20% 5% 1% 143
144 13.6% (ΗΜΓ) (ΗΧΓ) ΗΜΓ ΗΜΓ ΗΧΓ α ( ) β χ (ΛΠ ) δ ε φ 7 ΗΜΓ 1 2 ( ΦΣΗΛΗ75υ)
12 24 Β ΗΜΓ 1 2 8χµ 600 800πγ/ µλ Β ε18µµ ΗΜΓ ΗΜΓ24 36 Η ΧΓ5000 10000υ ΗΧΓ 2 3 150νγ/24 1500πγ/µλ ΗΧΓ ΗΜΓ ΗΧΓ 10000υ 4 5 2000 3000υ ΗΜΓ ΗΧΓ ΗΧΓ 145
ΗΜΓ ΗΧΓ 90% 50% 70% ΗΜΓ 10% 30% 3 5% ΗΜΓ 30% 3 2.5µγ 146
1 ( ) 5 7.5µγ 2.5µγ ( ) 16 18 60% 68 60(88.2%) 52 (76.5) 2 81% 42% 16% (ΓνΡΗ) 147
(ΓνΡΗ) 50µγ α (ΓνΡΗ ) ΓνΡΗ 5 10µγ ΓνΡΗ ΓνΡΗ 80 ΓνΡΗ 90 120 1 2 20 γ 90 120 ΓνΡΗ2.5 5 γ 10 20 γ 1 2 ΗΧΓ1500υ 3 3 ΓνΡΗ 70% 96% 50% 90 % ΓνΡΗ ΗΜΓ ΗΧΓ 148
ΗΜΓΗΧΓ Κλοππερ 1971 32 2 20µγ 4 40µγ 80µγ 81% 18 32 28 18 5 20µγ 2 5 12 66.7% 10 90% 149
150 (1) ΗΧΓ 5 7 ΗΧΓ5000 10000υ 12 18µµ ΗΧΓ5000υ (2) 0.5µγ 50µγ (3) ΗΜΓΗΧΓ 100µγ 5 4 ΗΜΓ2 Β ΗΧΓ5000 10000υ ΗΜΓ (4) ΗΜΓ ΗΧΓ
(5) ΓνΡΗ 6 4 100µγ 5 6 8 ΓνΡΗ100 γ 1 4 3 2 4 6 (6)ΓνΡΗ ΗΜΓ 5 ΓνΡΗ5 γ 20 γ 90 ΓνΡΗ9 32 Η ΜΓ2 4 25 7 4 1 2 151
152 1µγ (1) 5 Ηεγαρ 2 3 (2) (3)
153 (4) (5) ( ) Ε (1) (2)
154 (3) 30% 40% ( ) (4) 6 12 (5) (6) Ηεγαρ (7) (8)
α β 3 5 20 2 3 7 10 (ΗΧΓ) 1000 3000υ 5 155
α β χ α 156
157 β χ 3 α β 20% 30% (1)
1 υ 5µγ υ 10 20υ 4 8 0.5 1γ α 10 25µγ β 1υ 1 χ 100 200µγ 5 10µγ 0.2 1.0µγ 1 10 20µλ 2 3 (2) ΠΑΣ (3) 158
159 (1) (Τυρνερ) 47 (2) (3) (4) (5)
160 (6) αναζολ( 17 ) (7) ΦΣΗΛΗ α β ΛΗ ΡΗ χ δ ε
(1) α 10.25µγ β (ΓνΡΗ) 75% 20% 5% ΓνΡΗ Ναφαρελιν 1000 γ Βυσερελιν 200 µ γ 1 12 14 4.9 6.6νµολ/Λ 3νµολ/Λ 161
χ 2 6 50µγ/ 200µγ/ δ (ΧΠΑ) 5 14 50 100µγ 5 25 50 γ 50µγ/ 10 93.5% (300µγ) 70% 100% ε 400 1200µγ 3 6 (ΠΡΛ) 5 10µγ γφλυφαµιδε 2 250µγ 7 162
163 (2) 40 (1) 0.5 1µγ 1 22 11 ( )8 10µγ 1 10
164 16 10µγ 5 5 γ 1 20 22 (2) 0.5µγ 0.25µγ( 12.5 γ) 1 31 2 3 ΦΣΗΛΗ ΗΜΓ (3) (4) (1) 2
3 ΧΤ ( ) (2) 1969 47% 96% 2.5 10µγ 2.5 7.5µγ 2.5µγ 20µγ 1.25µγ 1.25µγ 27 2.5µγ 73% 100% 1 85% 57% 100% α 50 γ 24 76% 89% 2 165
β 8 96.5% 57.1% 72.4% 24.1% χ ΣΡΟ 2.5 5µγ 5 15µγ δ Χς205 502 ΛΑ( )ΛΑΡ( ) (3) ΗΜΓ ΓνΡΗ 6 10 15γ 15γ 3 0γ 24γ 30γ 15γ 12γ 15γ 30γ 200 300µλ 5 6 15γ 12γ 12γ 6γ 166
167 15γ 15γ 30γ 30γ 30γ 18γ 9γ 11 16 15γ 30γ 24γ 15γ 30γ 15γ 15γ 12γ 12γ 12γ 9γ 12γ 200 300µλ 6 17 25 15γ 30γ 15γ 30γ 15γ 15γ 30γ 15γ 24γ 30γ 12γ 200 300µλ 6 8 25 28 15γ 12γ 15γ 12γ 30γ 15γ 15γ 30γ 12γ 12γ 12γ 6γ 200 300µλ 3 5
10µγ 0 0 6γ 2 3 2 3µγ 300µγ 20µγ 10 5 50µγ 11 5Β ε18µµ (ΗΧΓ)5000 10 000ΙΥ ΗΧΓ 0.5 1.0µγ 1 22 5 20µγ Β ΗΧΓ 237 32.06% 26 6% 5.1% 4.04% 168
4.9% 12% 4% 7 16 1 200µγ 9 100µγ 10 33 10 100µγ 3 54 22 36 1 2980.5% ( ) 100µγ 2 10 1 169
170 (ΠΧΡ) 0.5γ 4 0.1γ 7 2γ 1γ 0.1γ 12 14 2/3 0.25γ 14 7
171 (1) ΗΧΓΗΜΓ (2) (3) (4) (5) (ΑΙΗ) (ΑΙ )
172 (6) (1)
3 0.1 0.3γ 3 0 05 0 1γ 2 3 10µγ 2 3 0.2γ (2) 3 6µγ 10 (3) 1 3 25 50µγ 10 30µγ (4)ΠΙΠΕ 60µγ 1µγ Ε1 ΠΙΠΕ ΠΙΠΕ 3 5 173
(5) 410 67.56% 29 02% 22.43% 6 6% (6) (7) 986 12 2 70% 53% 1 /µλ 1 1 /µλ 85% 70% 1 / µλ 174
175 35% 27% 55% 45% 165000 1 9γ 9γ 15γ 9γ 9γ 9γ 9γ 9γ 10γ 12γ 9γ ( )15γ 1 1
176 1µλ5% 30 50µγ 6γ 9γ 12γ 12γ 9γ 30γ 9γ 12γ 9γ 12γ 9γ 6γ 30 106 1 5 90.6% 31.1 %
177 α (ΓνΡΗ) ΑΤΠ( ) 20µγ α 200 600µγ 3 3 6
178 β Α 2 313 3 Α χ Ε 150µγ 1 3 Ε Ε δ 15γ () 9γ 12γ 15γ 18γ 12γ 15γ 9γ 168 94.6% ε (1)
(ΤΜΠ) (ΤΜΠ) (ΡΦΠ) ΤΜΠ80µγ/ ΡΦΠ 300µγ/ 1 2 15 2 15 1 90 311 1410.2 0.5 7 10 8 1 6 (2) 25 50µγ 3 100µγ 3 4/ 1 179
0.5γ 4/ 100µγ 30γ 1/ 1 2 1 15γ 12γ 9γ 3 1 ( ) 70% 85% 200µγ 100µγ 2 180
181 2γ 4 3 30 1 40 28 8 90% 97% 99% 95% β χ 90% α β 1)
25 50µγ 3/ 30 60 50 75µγ 25 50 µγ 3/ 5µγ 10 15 2) 80µγ 2/ χ 1) 2) δ 1) 2) 3 4 3γ 5% 2 µλ 182
183 10% 90% 0.25 0.5γ 3 1 0 125 0.5γ 3 63 Β1Ε α β 50µγ χ
184 3 6 δ 18γ 15γ 12γ 10γ 26 84.8% ε 85 5% φ 90% 41% 20% (10 ) (ΗΧΓ) (ΓνΡΗ) ΛΗΡΗ ΗΧΓ Λεψδιγ
185 ΓνΡΗ ΓνΡΗ ΓνΡΗ ΗΧΓ 14% 50% 10000υ 15000υ ΓνΡΗ 13% 70% 3 400 γ 4 1 ΓνΡΗ4 1.2µγ ΗΧΓ3 1500υ 73% 6 10% α β χ 10 ΓνΡΗ 3 400 γ δ ΗΧΓ1500υ 3 ε ΓνΡΗ φ 2 γ η Βυσ ερελιν(χνρη )10 γ 5 6 Λεψδιγ
7 2/3 ( 70% 30%) 1/3 8% 72% 20% 2.6% 2 5 α 2 5 80% 186
β (Η) (Ρ) (Ζ) (Στ) 4 1988 (2ΗΡΖ/4ΗΡ) 4 6 300µγ/ 50κγ 450µγ 50κγ 600µγ 25 µγ/(κγ/δ) 50κγ 1.5γ 50κγ 2γ 900µγ 600µγ 3 187
4 ΣΜΖ+ΤΜΠ( ) 2 2 188
189 2 3 12 2 4( 382µγ ) 5 7 1 2
190
191 5µγ 3 6 0.75µγ 31 12 1 10.75µγ 3 6 21 26 96 15 20 1 3 30γ 15γ 15γ 12γ 15γ 30γ 20γ 15γ 12γ 12γ 30 1 1 3 200 93%
192 480 1γ 1989 45% (1) 250µγ 100µγ 2 7 (2)
500µγ 1 2γ α ( ) 1 β ( ) 2 800µγ 2 1γ χ 1 δ 1 500µγ δ 100µγ 27 ε 3γ 1γ 1 500µγ 47 (1) (2) 193
194 (3) 1 2 (4) (5) 1 1 1% 0.5% 1% (6) 1989 (1) 2 Γ1.8γ(240 )
100µγ 22 α 500µγ 42 250µγ 1 10 (2) 1 Γ720 3 3 1 1 100µγ 24 (3) 200 400 4 1 1200 2400 10 14 1 α 200400 500µγ 410 14 Γ 240 3 195