课件：雄激素与男科疾病.ppt

* This study confirmed a change in Bio-T of aging males and investigated the relationship between Bio-T and other hormonal measures as well as relationship between Bio-T and sexual dysfunction and depression. Study included 130 patients (age:20-79 median 42) Endocrinological profiles were evaluated as appropriate Sexual function Depression PADAM Results: T, Bio-T and SHBG: Bio-T and free T decrease with age The IIEf 5 score for erectile function increased significantly with increases in Bio-T (r=0.792, p=0.0365) Relationship between the depression score and Bio-T was not significant The IIEF-5 score increased significantly in relation to increased serum Bio-T. Although sexual dysfunction did not involve endocrinological ED in all of subjects in the study, this finding may contribute to the discovery of the reason for a high prevalence of ED in aging males. * In Viagra non-responders, above 83% has low libido compared with responders who has 20% has low libido. Testosterone is a principal hormone responsible for the formation and maintenance of libido, sexual interest and sexual activity in men. The age group for this study, was 43-79. * Demographic: no differences between the groups were found except for the types of ED. Retrograde ejaculation Ejaculation tarda Decreased libido In 84 of the patients (70%) previously not responding to Viagra alone, the combined therapy resulted in the satisfactory increase of sexual functioning and in a significant increase in the IIEF. After discontinuation of Andriol, recurrence of ED was observed after 2 weeks in 100/120 patients. * * * * * * * * 克氏综合征Klinefelter Syndrome 诊断要点 1.典型体征：睾丸细小，容积小于3ml，质硬，身材修长，下肢长，第二性征不发育或发育差，皮肤细腻，乳房女性化，阴茎短小 2. 智力发育迟缓，性格和行为异常表现，精神障碍 3.性功能异常及不育。 4.睾丸活检:曲细精管玻璃样变性。 5.染色体核型多表现为47XXY或46XY/47XXY嵌合体。 6.内分泌检查:FSH和LH ，T 7.精液检查无精子 克氏综合征Klinefelter Syndrome 治疗 1.早期心理治疗及特殊教育 2.青春期前期药物治疗：最佳年龄11～12岁，尽管无助于生育，可促使学习提高，增强自信心。雄激素的首次剂量50～100mg,以后每2～4周增加50～100mg，直到成人用量，一旦治疗开始，就应维持终身。 3.成人药物治疗：可促成男性第二性征发育、改善性功能，改进