男性迟发性性腺功能减退症的诊疗指南  

Guidelines for diagnosis and treatment of late-onset hypogonadism in males

作　　者：中国老年保健协会生长发育和性腺疾病专业委员会 伍学焱[2] Growth and Development and Gonadal Diseases Committee of Chinese Aging Well Association;Wu Xueyan(不详;Department of Endocrinology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]不详 [2]中国医学科学院北京协和医学院北京协和医院内分泌科,北京100730

出　　处：《中华医学杂志》2025年第9期650-660,共11页National Medical Journal of China

摘　　要：迟发性性腺功能减退症(LOH)是中老年男性随着增龄而出现睾酮水平降低,引起性欲减退和勃起功能下降、体能下降和情绪低落等症状,伴随出现腹型肥胖、糖尿病和肌少症等代谢异常。LOH的诊断和治疗与广大中老年男性的健康状态和生活质量密切相关,因此成为医学界关注的焦点。近10年积累的临床数据,为LOH诊治相关的争议问题提供了充分的证据。中国老年保健协会生长发育和性腺疾病专业委员会组织了国内来自内分泌科、男科、泌尿外科、老年医学科、中医科、营养科、检验科、心血管科、神经内科、心理医学科、血液科、骨科、基础医学、药物学等领域52位专家,以牛津大学循证医学中心临床证据水平分级和推荐级别为依据,围绕LOH的诊断、睾酮补充的风险和获益等关键科学问题制订本指南。再结合德尔菲法评价意见,最终确定17条推荐意见,以帮助临床医师合理应对LOH。Late-onset hypogonadism(LOH)refers to the decline in serum testosterone levels in middle-aged and elderly men with aging,causing symptoms such as decreased libido,erectile dysfunction,and reduced physical and mental activity,as well as metabolic abnormalities such as abdominal obesity,diabetes and myopenia.The diagnosis and treatment of LOH are closely related to the health and quality of life of middle-aged and elderly men.It has been a focus of medical attention.The clinical data over the past decade provide substantial evidence for these issues.Consequently,Growth and Development and Gonadal Diseases Committee of Chinese Aging Well Association organized 52 experts in endocrinology,andrology,urology,geriatrics,traditional Chinese medicine,nutrition,laboratory medicine,cardiology,neurology,psychiatrics,hematology,orthopedics,basic medicine,pharmacology and othe fields.Based on the Oxford Center for Evidence-Based Medicine′s level of clinical evidence and recommendation levels,the guidelines have been developed around the diagnosis of LOH,the risks and benefits of testosterone supplementation.Combined with the evaluation opinions of Delphi method,17 recommendations were finally formulated to help clinicians cope with LOH.

关 键 词：性腺功能减退症 男性 睾酮 睾酮补充治疗 诊断 

分 类 号：R73[医药卫生—肿瘤]