男性更年期综合征的心身特点

Psychosomatic Characteristics of Male Climacteric Syndrome

目的:探讨男性更年期综合征的临床特征。方法:以主动到心理咨询门诊的男性更年期综合征患者60例为研究组(A组),以女性更年期综合征患者148例为女性对照组(B组),另有来自大学和医院的男性职工62人为正常对照组(C组)。采用一般资料、Locke-wallace婚姻调适测定、生命质量评定量表(TDL)、生活事件评定量表(LES)、应激量表(WSP)、社会支持量表(SSRS)、艾森克人格问卷(EPQ)等,从心身角度对A、B两组进行多方面的对照,且对A组与C组进行了性激素测定对照,对A组血清睾酮、雌激素水平与更年期症状(Kupperman评分)进行了相关分析。结果:①A组不良生活方式、伴发躯体慢性疾病比例及婚姻质量评分高于B组(32/60、28/148;19/60、26/148;107.2±11.0、70.6±22.7,χ2=24.64、5.01、t=11.89,P<0.01),而B组神经质性人格比例高于A组(66/148、12/60,χ2=11.02,P<0.01)。②A组LES、SSRS分值高于B组(70.1±23.2/62.2±15.5,53.3±5.0/20.8±7.0,t=2.88、32.93,P<0.01),B组WSP分值高于A组(35.5±2.8/30.0±5.9,t=9.08,P<0.01)。A、B两组Kup-perman总分比较差异无显著性,但因子分差异有显著性。③A组雌激素水平显示高于C组(40.8±9.2/35.7±10.3,t=2.86,P<0.05)。④A组血清睾酮与Kupperman总分无相关(r=0.03,P>0.05),但雌激素与Kupperman总分呈正相关(r=0.57,P<0.01)。结论:男性更年期综合征的临床特征有别于女性,血清雌激素水平可能与男性更年期症状的产生有关。

Objective： To study the clinical characteristic of male climacteric syndrome. Methods： 60 male patients with climacteric syndrome initiatively came to hospital for psychological consulting were collected as Group A （ study group） . 148 female patients with climacteric syndrome were collected as female case control（ Group B） , and the 62 healthy male voluntarily participated the study as health control （ Group C ） . The investigation included general data, marital quality scale （Locke-Wallace）, life quality scale （TDL）, life events scale （LES）, stress scale （WSP）, social support scale （SSRS）, Eysenck Personality Questionnaire （EPQ） . The sex hormone level of Group A and Group C were compared, including the serum testosterone, female hormone level and climacteric syndrome （Kupperman） . Results： （The ratio of the patients in Group A with bad life style and chronic somatic diseases were higher than Group B （ 32/60 vs. 28/148, 19/60 vs. 26/148, X^2 = 24.64, 5.01, P 〈 0.01 ） . Group A had also higher score in marital quality scale than Group B （ 107. 2 ± 11.0/70.6± 22. 7, t = 11.89, P 〈 0. 01 ） . but the ratio of neurotic characters （EPQ） was higher in Group B than in Group A （66/148 vs. 12/60, X^2 = 11.02, P 〈 0. 01 ） . ② LES, SSRS scores of Group A were higher than those of Group B （ 70. 1 ± 23.2/62. 2 ±15.5, 53.3 ±5.0/20. 8± 7.0, t = 2.88, 32. 93, P 〈 0. 01 ）, WSP score of Group B was higher than that of Group A （ 35.5 ± 2.8/30.0 ± 5.9, t = 9.08, P 〈 0. 01 ） . There was no significant difference for Kupperman total score, but the factor score had some differences between A and B groups. ③ The estrogen level of Group A was higher than that of Group C （40. 8 ± 9. 2/35.7 ± 10. 3, t = 2. 86, P 〈 0. 05 ） . ④The serum testosterone of Group A had no correlation with Kupperman score （ r =0.03, P 〉 0. 05 ） ; but the estrogen level had a positive correlation with Kupperman score （ r = 0. 57, P 〈 0. 01 ） . Conclusion： The clinical characteristics of male climacteric syndrome are different from those of the female. The serum estrogen level is associated with the emergence of male climacteric syndrome.