勃起功能障碍患者血清生殖激素分析.docVIP

勃起功能障碍患者血清生殖激素分析 　　【摘要】目的：通过观察勃起功能障碍（ED）患者血清生殖激素的变化情况，探讨血清生殖激素与ED之间的相关性。方法：2009年11月至2014年6月，按照当地人口统计局资料，采用经整群及年龄分层的随机抽样方法，调查40～80岁共计3000例有固定性伴侣的中老年男性社区居民。采用勃起功能国际指数（IIEF）评估ED及严重程度，化学发光法（CLIA）检测血清总睾酮（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：华东地区中老年男性人群的ED发病率为76.75%，其中轻度ED 47.56%，中度ED 10.41%，重度ED 18.78%。TSI及Bio-T随ED患者勃起功能评分的下降而明显降低（P0.0001），SHBG随着勃起功能评分下降而显著升高（P0.0001）。TT在不同程度的ED患者之间没有变化规律。Pearson相关分析显示：TSI及Bio-T与ED严重程度呈现显著的负相关，SHBG与ED严重程度呈显著正相关，TT与ED无明显相关性。结论：Bio-T及SHBG对ED患者的诊断价值优于TT，TSI、Bio-T的下降及SHBG的增高应作为ED患者重要的睾酮水平指标。 　　【关键词】勃起功能；睾酮游离指数；游离睾酮；生物活性睾酮；性激素结合球蛋白 　　【Abstract】Objectives： To observe the changes of serum reproductive hormone in erectile dysfunction （ED） patients， inn order to assess the correlation between serum reproductive hormone and ED patients. Methods： A cross-sectional randomized study of 3000 men aged from 40 to 80 years was performed in Shanghai and Zhejiang community. The erectile function （EF） was evaluated by International Index of Erectile Function 5 （IIEF-5）. The serum total testosterone （TT）， luteinizing hormone （LH） and sex hormone-binding globulin （SHBG） were measured by chemilum inescentenzyme immunoassay （CLIA） method， while testosterone secreting index （TSI）， free testosterone （FT） and bioavailable testosterone （Bio-T） were calculated respectively. Results： The prevalence of ED was 76.75% in eastern China， of which the rates of mild， moderate and severe ED were 47.56%， 10.41% and 18.78% respectively. The concentration of TSI， Bio-T and SHBG were closely correlated with IIEF score on ED domain （P0.0001）， but this was not the case with TT. Pearson regression analysis revealed that the concentration of TSI， Bio-T and SHBG were significantly related to IIEF score， but not with TT. Conclusion： Both SHBG and Bio-T is much more effective than serum TT in diagnosis of ED. TSI/Bio-T declining and SHBG increasing plays a critical role in reflecting the testerone level of ED patients. 　　【Key words】Erectile funct