雄性激素与男性性腺功能减退症诊断及治疗__培训课件.pptVIP

* * 在年轻人中，睾酮的分泌存在昼夜节律，从早上到晚间，睾酮是下降的，而从夜间8点到第2天的早晨，睾酮水平又升高。这样周而复始。 但是老年人丧失了这个节律，基本保持在一个浓度水平上。 NOTES Older studies concerning the relationship of serum testosterone levels to aging in normal men have yielded apparently conflicting results. Studies performing blood sampling in the morning have often shown an age-related decrease in testosterone levels, whereas those using afternoon samples have failed to show such a decrease. These results suggested the possibility that the circadian rhythm in serum testosterone levels might be altered with normal aging in men. Hourly blood samples were obtained for 24 hours from 17 young (mean age 25 years) and 12 old (mean age 71 years) healthy men and total testosterone levels were measured by RIA. The circadian rhythm in serum testosterone levels found in normal young men was markedly attenuated or absent in healthy elderly men. The early morning rise in testosterone levels characteristic of young men was not present in old age. Mean testosterone levels for the entire 24-hour period were lower in healthy old men than in young men. The reason for the loss of circadian rhythm of testosterone secretion is probably related to a disturbed pituitary gonadotropin secretory pattern. These results demonstrate a clear decrease in serum testosterone levels in healthy old men compared to those in young men and provide an explanation for the inability to demonstrate an age-related decline in testosterone levels in earlier studies using serum samples obtained in the afternoon. Reference Bremner WJ, Vitiello MV, Prinz PN. Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. J Clin Endocrinol Metab 1983;56:1278-1281 * 那么会有哪些表现和症状呢？ * 这项调查显示，50岁以上男性各项症状可能出现的比例。80%的有性欲低下和精力不足的表现。其他常见的还有勃起功能障碍、记忆力下降，掉头发，情绪的改变如烦躁易怒等，耐力也下降等等。 * * 那么什么是男性性功能障碍呢？正常男性的性功能包括性欲、阴茎勃起、附属性腺分泌、性交、射精或曰性高潮和勃起消退等一系列环节。如果其中某一环节或多个环节发生异常，则会导致性功能或性感受的不全或缺失，这种状况称为男性性功能障碍。 看这个图，作为一个男人有性功能障碍要承受很大的心理压力。 * * 横断面研究，有64名住在疗养所的孱弱老年男性（平均年龄85岁；年龄范围63-100岁）