症状性迟发型性腺功能减退合并勃起功能障碍患者血清生殖激素分析  

Analysis of serum reproductive hormones in patients with erectile dysfunction and symptomatic lateonset hypogonadism

作　　者：梁国庆[1] 李建辉[2] 郑俊彪 于晓华[2] 施慧娟[3] 朱虔兮[3] 王峻[2] 李余敏[2] 孙建明[1] 张树成[4] 李铮[5] 

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200137 [2]浙江省嘉善县第一人民医院泌尿外科,嘉善314100 [3]上海市计划生育科学研究所,上海200032 [4]国家人口计生委科学技术研究所,北京100081 [5]上海交通大学附属第一人民医院泌尿外科医学中心,男科与盆底尿失禁外科,上海200080

出　　处：《上海交通大学学报（医学版）》2016年第11期1613-1616,1621,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海中医药大学附属第七人民医院人才培养计划(No.QMX2016-02);国家科技基础性工作专项(No.2013FY110500)~~

摘　　要：目的·通过观察症状性迟发型性腺功能减退（SLOH）合并勃起功能障碍（ED）患者血清生殖激素变化情况,探讨生殖激素与SLOH合并ED（SLOH/ED）的相关关系。方法·采用问卷调查的方式,经整群及年龄分层多阶段不等比例的随机抽样方法,抽取3 000例40～80岁有固定性伴侣的社区中老年男性作为研究对象。采用老年男性症状（AMS）量表评估SLOH及其严重程度,采用国际勃起功能指数问卷表-5（IIEF-5）评估勃起功能,同时检测血清总睾酮（TT）、游离睾酮（FT）、黄体生成素（LH）和性激素结合球蛋白（SHBG）水平,计算生物活性睾酮（Bio-T）水平,单因素和多因素Logistic回归分析生殖激素与SLOH/ED的相关关系。结果·共获得2 588例符合条件的完整研究资料,平均年龄（57.95±8.50）岁。930例（35.94%）男性观察到SLOH（AMS≥27）症状,其中812例（31.38%）男性同时存在ED。739例（28.56%）男性既无SLOH亦不存在ED症状。Logistic回归分析显示TT及FT水平与SLOH/ED的相关关系不明显,年龄、SHBG和Bio-T与SLOH/ED的相关关系有统计学意义（P〈0.01）。结论·SHBG和Bio-T与SLOH/ED显著相关,能准确反映SLOH/ED患者的皿清生殖激素水平。Objective · To explore the correlation between reproductive hormones and symptomatic late-onset hypogonadism combined with erectile dysfunction （SLOH/ED） via observing the changes in serum reproductive hormones in patients with SLOH/ED. Methods · Questionnaire survey was used and 3 000 males aged 40 to 80 years with regular sexual partners were selected with random cluster and age-stratified multi-phase disproportionate samplings. SLOH was evaluated with the aging male symptoms （AMS） scale. ED was evaluated with the simplified international index of erectile function （IIEF-5）. Serum reproductive hormones such as total testosterone （TT）, free testosterone （FT）, luteinizing hormone （LH）, and sex hormone-binding globulin （SHBG） were examined. Bioavailable testosterone （Bio-T） was calculated. The correlation between reproductive hormones and SLOH/ED was analyzed using univariate and multivariate Logistic regression analyses. Results · The study population consisted of 2 588 eligible males with a mean age of （57.95±8.50） years. SLOH （AMS≥27） was observed in 930 （35.94%） males. Of them, 812 （31.38%） had ED. 739 （28.56%） had neither SLOH nor ED. Logistic regression analyses revealed that TT and FT levels were not significantly correlated with SLOH/ED, while the correlation of age, SHBG, and Bio-T with SLOH/ED was statistically significant （P〈0.01）. Conclusion · SHBG and Bio-T are significantly correlated with SLOH/ED and can correctly reflect reproductive hormone levels in patients with SLOH/ED.

关 键 词：症状性迟发型性腺功能减退 勃起功能障碍 生殖激素 性激素结合球蛋白 生物活性睾酮 

分 类 号：R698.2[医药卫生—泌尿科学] R588[医药卫生—外科学]