男性迟发性性腺功能减退症患者血清性激素分析  

Study of serum sex hormone in men with late onset hypogonadism

作　　者：梁国庆[1] 孙建明[1] 李建辉[2] 郑俊彪 王峻[2] 李余敏[2] 施慧娟[3] 朱虔兮[3] 张树成[4] 于晓华[2] 

机构地区：[1]上海中医药大学附属第七人民医院男性病科,上海市200137 [2]嘉善县第一人民医院泌尿外科,浙江省嘉兴市314100 [3]上海市计划生育科学研究所,上海市200032 [4]国家人口计生委科学技术研究所,北京市100081

出　　处：《实用老年医学》2016年第9期723-725,共3页Practical Geriatrics

基　　金：上海市卫生局课题(20134392);国家科技基础性工作专项(2013FY110500);上海中医药大学附属第七人民医院人才培养计划(QMX2016-02)

摘　　要：目的通过观察老年男性迟发性性腺功能减退症（late onset of hypogonadism,LOH）患者的血清性激素变化情况,探讨性激素对LOH的诊断意义。方法 2009年11月至2014年6月,采用分层多阶段整群抽样方法,选择上海市及浙江省嘉善县17个社区3000例40~80岁中老年男性作为调查对象,分别记录国际勃起功能（IIEF-5）问卷及老年男性症状（AMS）量表,同时测定其血清总睾酮（TT）、黄体生成素（LH）、性激素结合球蛋白（SHBG）,计算睾酮游离指数（TSI）、游离睾酮（FT）及生物活性睾酮（Bio-T）。结果研究对象平均年龄为（58.47±8.15）岁,AMS量表筛查LOH的阳性率为34.92%（937/2683）。LOH阳性组人群的TT和LH水平与阴性组比较差异无统计学意义（P〉0.05）;FT、TSI在LOH阳性组较阴性组明显降低（P〈0.05）;SHBG及Bio-T在2组间差异亦有统计学意义（P〈0.01）。Pearson相关分析显示：TSI、SHBG及Bio-T与LOH显著相关,FT与LOH弱相关,而TT及LH与LOH无明显相关性。结论 SHBG及Bio-T对LOH患者的诊断价值优于TT,Bio-T的下降及SHBG的增高应作为LOH患者重要的诊断指标。Objective To observe the changes of serum sex hormone in the patients with late onset of hypogonadism（ LOH）,and to assess its value for diagnosis of LOH. Methods A cross-sectional randomized study of 3000 males aged 40 to 80 years were investigated under structured questionnaires including IIEF-5 and AMS from November 2009 to June 2014 in Shanghai and Zhejiang community. The levels of total testosterone（ TT）,luteinizing hormone（ LH） and sex hormone-binding globulin（ SHBG） were detected,and testosterone secreting index（ TSI）,free testosterone（ FT） and bioavailable testosterone（ Bio-T） were calculated. The International Index of Erectile Function-5（ IIEF-5） and Aging Male Symptoms（ AMS） were evaluated. Results The mean age of the males was（ 58. 47±8. 15） years old. The positive rate of LOH screened by AMS was 34. 92%. FT and TSI values were lower in LOH patients than those in normal men（ P〈0. 05）,however,no statistical difference was observed in TT and LH between two groups. The levels of Bio-T and SHBG were closely correlated with LOH（ P〈0. 01）. Pearson correlation analysis indicated that TSI,SHBG and Bio-T were significantly related to LOH（ P〈0. 05）. Conclusions Both SHBG and Bio-T play a critical role in reflecting the testerone level of LOH patients. The levels of Bio-T decling and SHBG are important bio-markers to diagnose LOH.

关 键 词：迟发性性腺功能减退症 游离睾酮 性激素结合球蛋白 生物活性睾酮 

分 类 号：R588.1[医药卫生—内分泌]