对勃起功能障碍患者血清游离睾酮及睾酮分泌指数的初步研究

A Preliminary Study of Serum Free Testosterone and Testosterone Secreting Index in Men with Erectile Dysfunction

目的:通过观察勃起功能障碍(ED)患者的血清游离睾酮(FT)、睾酮分泌指数(TSI)的变化,探讨两者在ED内分泌病因中的诊断价值。方法:120例ED患者及30例正常婚检者均来自于江苏省中医院男科门诊和病房,分别进行勃起功能国际指数(IIEF)问卷中勃起功能评分和性欲评分,采用化学发光法(CLIA)检测血清总睾酮(TT)、黄体生成素(LH),放射免疫检测法(RIA)检测游离睾酮(FT),并计算睾酮分泌指数(TSI)。结果:120例ED患者中低于TT、FT参考值的患者分别占5%、15.8%;TT在不同年龄组ED患者中随年龄下降但无统计学差异,FT、TSI在不同年龄组ED患者中随年龄下降且有统计学差异。TT随IIEF评分的变化缺乏规律,而FT、TSI随IIEF评分降低且有统计学差异。TT、FT、TSI在ED患者不同性欲评分组无统计学差异。结论:FT在ED伴有性腺功能减退的诊断价值优于TT,FT、TSI是评估ED严重程度的重要参数。

Objective： To observe the changes of serum free testosterone （FT） and testosterone secreting index （TSI） in ED patients, and to assess the contribution of these two indexes to the diagnosis of ED caused by endocrine factors. Methods ： We studied 120 ED patients and 30 healthy men undergoing pre-marital medical check-up in Jiangsu Province Hospital of TCM by analyzing the scores on erectile function and desire domain in IIEF, testing the serum total testosterone, luteinizing hormone by chemiluminescentenzyme im- munoassay （ CLIA）, measuring free testosterone by radioimmunoassay（ RIA ） , and calculating TSI. Results： Of the 120 ED patients, 5% and 1538% were below the reference norm of Tr and FT values respectively. Tr, FT and TSI decreased with age, with statistical with FT and TSI, but not with Tr. FT and TSI statistically declined with lower IIEF score on ED domain, hut this was not the case with TY. There were no significant differences in TY, FT and TSI among different sexual desire groups the ED patients. Conclusion： FT is much more valuable than 37 in the diagnosis of ED with hypogonadism. Both FT and TSI are important parameters in assessing the severity of ED.