雄激素性秃发患者血清二氢睾酮水平与非那雄胺治疗疗效的关系

Reduction in peripheral blood dihydrotestosterone is not correlated with efficacy of finasteride therapy in patients with androgenetic alopecia

目的:探讨雄激素性秃发患者外周血二氢睾酮(DHT)、睾酮(T)与非那雄胺治疗疗效的关系。方法:把121例男性雄激素性秃发分成外周血DHT升高组(A组)64例和DHT正常组(B组)57例,分析其临床表现的特点,并将两组患者对非那雄胺治疗疗效积分的差异和DHT、T的变化,以及性勃起功能与DHT的关系进行对比观察。结果:A组患者平均年龄为(25.64±4.25)岁,B组患者平均年龄为(29.38±6.35)岁,A组患者的年龄和发病年龄比B组早,两组患者伴发家族史、病情严重程度无差异、对非那雄胺治疗的疗效、起效时间无差异。A组DHT水平与年龄、病情严重程度呈负相关;两组DHT下降与疗效积分无关,T升高亦与疗效积分无关;DHT的下降与勃起功能障碍相关。结论:雄激素性秃发患者外周血DHT越高,发病年龄越早;对非那雄胺治疗的疗效与外周血DHT水平无关,随着其疗效的提高外周血DHT会出现下降的趋势,但与下降的幅度无关:勃起功能障碍与外周血DHT下降有关。

Objective： To explore the correlation between the serum testosterone ＆ dihydrotestosterone （DHT）, testosterone （T） and finasteride therapy among patients with androgenetic alopecia （AGA）. Methods： Divide 121 males with androgenetic alopecia into two groups as Increased Peripheral Blood DHT Group （Group A） of 64 males and Normal DHT Group （Group B） of 57 males, to analyze the clinical features, compare and observe the distinction of efficacy on finasteride therapy, the variation in DHT ＆ T and the correlation of sexual erection and DHT. Results： The average age of Group A was 25.64±4.25, and Group B 29.38±6.35. The age and onset age of Group A were younger than Group B, but it was found no differ ence between the two groups on familial history, disease severity, efficacy of finasteride therapy and time to start to effect. For Group A, DHT level was negatively correlated with age and disease severity, but for the two groups, DHT reduction had no relation with the clinical efficacy and the total score, and the same for DHT increase, while DHT reduction had relation with erectile dysfunction. Conclusion： For the andorgenetic alopecia patients, the higher peripheral blood DHT, the younger onset age. And the efficacy of finasteride therapy is not correlated with peripheral blood DHT, but DHT will incline to decline as the efficacy of finasteride therapy increases, yet there is no relation between the efficacy of finasteride therapy and DHT reduction range. And the erectile dysfunction is correlated with reduction in peripheral blood DHT.