雄激素对老年男性认知功能的影响

Effect of testosterone on cognitive functions in elderly male patients

目的研究老年男性雄激素与认知功能的关系,分析其可能机制。方法老年男性87例,按简易智能量表(MMSE)评分分为认知功能障碍组和认知功能正常组;用放射免疫法测定所有病例的血清睾酮及雌二醇水平;分析认知功能障碍组患者睾酮与几项常见认知功能的关系。结果两组间睾酮水平、雌二醇水平及年龄差异有统计学意义(P<0.05),其中睾酮水平与认知功能联系更强(P<0.01);睾酮水平主要与空间、注意力等认知功能相关(其中积木试验r=0.752,P<0.01;数字广度试验r=0.690,P<0.01;图形旋转试验r=0.548,P<0.05;连线B试验r=0.572,P<0.05);控制年龄因素、雌二醇因素后,睾酮水平与空间、注意力等认知功能仍相关(P<0.01)。结论雄激素水平主要影响老年男性空间、注意力等认知功能,且不受雌激素的影响。

Objective To investigate the relationship between serum levels of testosterone and cognitive functions in elderly male patients, and to discuss the probable mechanism. Methods Eighty-seven elderly male patients were divided into two groups according to the Mini Mental State Examination（MMSE） scores： impaired cognitive functions group（ n = 39） and normal cognitive functions control group （n = 48）. Serum testosterone and estradiol concentration of all the patients were measured by radioimmunologieal method. Furthermore, the patients in impaired cognitive functions group were given a battery of common cognitive tests to evaluate cognitive functions in detail. Results There were significant differences between two groups in testosterone,estradiol concentrations as well as age （P〈0. 05） ,and the testosterone concentration was more significantly associated with poor cognitive performance（ P〈 0.01）. Testosterone levels especially influenced the functions of spatial abilities and attention（Block Design test r = 0. 752, P 〈0. 01 ;Digit span test r =0. 690, P 〈0.01;Graphic rotation test r =0. 548, P〈0.05;Trail making test-B r= 0.572, P 〈0.05）, even when age and estradiol factor excluded. Conclusion Serum testosterone level had a selective relationship with cognitive functions in elderly male patients; it mainly affected spatial abilities and attention, which did not involve with estradiol.