成年男性性腺功能减退症400例的病因构成  

The etiological classification of 400 cases of adult male hypogonadism

作　　者：吕文戈[1] 史轶蘩[1] 邓洁英[1] 张殿喜[1] 卢双玉[1] 

机构地区：[1]中国协和医科大学北京协和医院内分泌科

出　　处：《生殖医学杂志》1996年第3期131-134,共4页Journal of Reproductive Medicine

摘　　要：成年男性性腺功能减退症可由多种病因引起，了解不同病因的构成比例有助于临床诊治。本文回顾分析本病４００例的病因构成。约２／５的患者为睾丸疾患，另３／５的患者为低促性腺激素性性腺功能减退症（ＨＨ）。睾丸疾患中８３％为Ｋｌｉｎｅｆｅｌｔｅｒ综合征。ＨＨ患者中３．３％为鞍区占位病变，３１．４％为鞍区发育不全。１６．８％的ＨＨ（１８．４的ＩＨＨ）合并垂体－性腺轴外的其他垂体前叶功能低减。提示临床中应注意检查嗅觉、染色体核型、鞍区影像学以及其他垂体前叶功能，以明确病因诊断。本文还讨论了某些病因类型的特点及诊断。Objectives: To analyze the common causes of adult male hypogonadism in China. Design: A clinical review study. Setting: Out Patient clinic in Department of Endocrinology, Peking Union Medical College Hospital. Subjects: 400 cases of adult male hypogonadism from August,1963 to July,1994. Methods:The case records of 400 cases were reviewed. The clinical assessment and the blood testosterone level measurement were performed to idaentify hypogonadism. Olfactory function, color blindness test, serum FSH,LH levels,karyotype and image examination of sella turcica region were tested to identify the causes. Other anterior pituitary functions were also assessed in required cases. Results: About 2/5 of the patients were hypergonadotropic,while the other 3/5 were hypogonadotropic(HH). Among the hypergonadotropic hypogonadisms,83% were Klinefelter syndrome Among the HH, 3.3% had space occupying lesion in sella turcica region, 31.4% were complicated with midfacial malformation which might be due to hypoplasia of sella turcica region,3.8% had a history of encephalitis or meningitis before the age of 10, the other 61.5% didn't have any determined causes. 16.8% of the HH (18.4% of the IHH) were complicated with other anterior hypopituitarism apart from the deficiency of pituitary gonad axis. Conclusion: The etiology of adult male hypogonadism is complicated. It is important to assess olfactory function,chromosomal karyotype, other anterior pituitary function and image examination of sella turcica region in order to clarify the cause of hypogonadism.

关 键 词：性腺机能减退 病因学 诊断 男性 

分 类 号：R588.102[医药卫生—内分泌]