低剂量甲睾酮和安雄治疗老年男性骨质疏松患者的对比研究  

Comparative study on the low-dosage methyltestosterone or andriol treatments of senile osteoporosis in men

作　　者：詹俊鲲[1] 刘幼硕[1] 王田琪[1] 黄武[1] 龙利民[1] 王艳姣[1] 王翼[1] 廖二元[2] 

机构地区：[1]中南大学湘雅二医院老年病科,长沙市410011 [2]中南大学湘雅二医院代谢内分泌研究所,长沙市410011

出　　处：《中华老年医学杂志》2008年第10期724-727,共4页Chinese Journal of Geriatrics

基　　金：中央保健委员会专项科研基金（2002湘B026）

摘　　要：目的比较低剂量甲睾酮及安雄（十一酸睾酮）对老年男性骨质疏松患者骨密度、生命质量的影响及安全性。方法选择血清游离睾酮水平低于正常值的老年男性骨质疏松患者134例，按用药方案分为甲睾酮组45例，甲睾酮1mg，1次／d舌下含服；安雄组46例，安雄40mg，1次／d口服；对照组43例，安慰剂，1次／d舌下含服。治疗时间为1年。测定治疗前后骨密度、骨代谢相关血和尿生化指标、生命质量指标和前列腺B超、血清前列腺特异抗原、血尿常规、肝肾功能等。结果低剂量甲睾酮和安雄均可防止老年男性骨质疏松患者各部位骨密度进一步下降（均为P〈0．05），股骨颈骨密度在甲睾酮组和安雄组治疗前后差值分别为（0．14±0．18）g／cm。和（0．12±0．09）g／cm。（P〈0．05）；安雄治疗在升高血游离睾酮[（32．5±14．2）ng／L]水平作用强于甲睾酮[（19．3±9．2）ng／L]（P％0．05）；两种激素均能改善患者总体健康、情绪角色功能和精力，低剂量安雄治疗在改善躯体健康和躯体角色功能方面优于低剂量甲睾酮。结论低剂量甲睾酮和安雄均可用于老年男性骨质疏松的治疗，同时可提高其生命质量，是一种安全、有效的治疗选择。Objective To evaluate the therapeutic efficacy of low dosage methyhestosterone or andriol in men with senile osteoporosis. Methods A total of 134 male patients with senile osteoporosis and the decreased serum level of free testosterone were divided into three groups. 45 patients were treated with low-dosage methyltestosterone（ 100 mg, once a day, sublingual） and 46 patients were treated with low dosage andriol （40 mg,once a day, orally）, while 43 patients were treated with placebo. The duration of treatment in each group was 1 year. The bone density, blood and urine biochemical indexes related to bone metabolites,the quality of llfe indexes, uhrasonography for prostate, serum prostate specific antigen, blood routine, urine routine, hepatic and renal function were detected before and after the treatment. Results Both low dosage methyltestosterone and low dosage andriol could prevent the decrease of hone mineral density and improve patients＇ general health, role-emotional function and vitality （all P〈0.05）. The difference values of femoral neck bone mineral density before and after treatment with low dosage andriol and low-dosage methyhestosterone were （0.14±0. 18）g/cm^2 and （0. 12±0.09）g/cm^2, respectively（P〈0.05）. Low-dosage andriol had stronger effects in increasing the level of estradiol （ 32.5 ± 14.2 ） ng/L than low dosage methyhestosterone（19.3 ± 9.2） ng/L（P〈0.05） and showed more notable effects in improving the physical functioning and role physical function than low dosage methyhestosterone. The use of the two androgenic hormones at low dosage showed safety. Conclusions Both low-dosage methyhestosterone and low-dosage andriol can be used to treat senile osteoporosis in men and to improve life quality. Both of them are effective and safe therapeutic choices.

关 键 词：甲睾酮 骨密度 生活质量 骨质疏松 

分 类 号：R686[医药卫生—骨科学]