摘要
目的:通过分析雄激素指标与迟发性性腺功能减退症(LOH)症状问卷的关系,明确各雄激素指标的稳定性,为如何应用2009年中华医学会男科学分会制定的LOH诊断标准提供参考。方法:纳入1 003例≥40岁中老年男性雄激素缺乏调查表(ADAM)、男性老龄化症状调查表(AMS)、IIEF-5问卷填写完整的男性,对雄激素指标与问卷结果进行相关性分析。对总睾酮(TT)≤11.5 nmol/L的31例在平均1.5年后复测各雄激素指标,分析影响各指标结果波动的因素。结果:①游离睾酮指数(FTI)≤0.42、计算游离睾酮(cFT)≤0.3 nmol/L是AMS问卷阳性的危险因素,OR分别为1.369、1.302;睾酮分泌指数(TSI)≤2.8 nmol/IU、cFT≤0.3 nmol/L是IIEF-5问卷阳性的危险因素,OR分别为1.679、1.371。②2次测定的TT、TSI、FTI、cFT、FT进行配对t检验,TT、TSI、cFT、FT均有显著差异(P<0.05)。结论:由于雄激素降低引起的症状存在多样性,而且雄激素水平存在一定波动,因此LOH诊断应联合多个症状问卷基础上结合各雄激素指标进行拟诊,睾酮治疗后症状改善才能确诊。
Objective： To determine the stability of androgen indexes by analyzing the relationship of androgen indexes with the results of late-onset hypogonadism （LOH） questionnaire investigations, and offer some reference for the application of the diagnostic criteria for LOH released by The Chinese Society of Andrology in 2009. Methods ： This study included 1 003 males aged 40 years or older who had accomplished the questionnaires of Androgen Deficiency in Aging Males （ADAM） , Aging Males＇ Symptoms Scale （AMS）, and International Index of Erectile Function-5 （IIEF-5）. We evaluated the correlation of androgen indexes with the results of the questionnaire investigation, repeated the examination of androgen indexes for the subjects with total testosterone （TT） ≤11.5 nmol/L after an average of 1.5 years, and analyzed the factors inducing changes of androgen indexes. Results ： Free testosterone index （FTI） ≤ 0.42 （OR, 1. 369） and calculated free testosterone （eFT） ≤0.3 nmoL/L （OR, 1. 302） were considered as the risk factors of LOH in AMS, and so were testosterone secretion index （TSI） ≤2.8 nmol/IU （OR, 1. 679） and cFT ≤0.3 nmol/L （OR, 1. 371 ） in IIEF-5. Paired t-test on the results of the examination performed twice showed significant differences in the levels of TT, TSI, eFT, and FT （ P 〈 0. 05 ）. Conclusion ： Decreased testosterone may cause the diversity of LOH symptoms and hence the fluctuation of androgens. Therefore, the diagnosis of LOH depends on androgen indexes, varied symptoms in the questionnaires, and relief of the symptoms after testosterone therapy. Natl J Androl, 2016, 22 （11） ： 979 -983
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2016年第11期979-983,共5页
National Journal of Andrology
关键词
迟发性性腺功能减退症
总睾酮
计算游离睾酮
睾酮分泌指数
游离睾酮指数
问卷
late-onset hypogonadism
total testosterone
calculated free testosterone
testosterone secretion index
free testos-terone index
questionnaire
