慢性肝病患者性腺功能的变化及与肝病严重程度的关系

The Gonadal Function Changes and Their Significance in Chronic Liver Diseases

研究慢性肝病男性患者性腺功能的变化及与肝病严重程度的关系。应用化学发光法测定162例慢性肝病男性患者的性腺激素水平,慢性肝病患者根据有无肝硬化分为肝硬化组及非肝硬化组,肝硬化的严重程度依据Child-Pugh标准分为A、B、C级,比较各组患者的性腺激素水平。研究发现42%的慢性肝病患者存在继发性性腺功能减退。慢性肝病患者的血清睾酮水平显著低于正常对照组,雌激素水平显著高于正常对照组,特别是存在肝硬化的患者更为明显。此外在肝硬化患者中Child-Pugh分级B级和C级患者的血清睾酮水平显著低于A级患者,雌激素水平显著高于A级患者。无性腺功能减退的慢性肝病患者其反映病情严重程度的生化指标如AST、ALT等显著好于存在性腺功能减退的患者。提示慢性肝病患者存在性腺功能的异常,性腺激素水平的测定对评价慢性肝病的严重程度具有一定的价值,可作为判断病情和观察治疗效果及预后的重要依据。

To investigate the gonadal function changes and their significance in chronic liver diseases. Serum gonadal hormone level was measured by chemiluminescence method in 162 male cases with chronic liver diseases. Patients with chronic liver diseases were divided into cirrhosis group and no cirrhosis group, and cirrhosis were graded into A, B, C grade with Child-Pugh. 42 % of patients with chronic liver disease have secondary gonadal dysfunction. Serum testosterone levels were significantly lower and estrogen levels were significantly higher in patients with chronic liver disease than those in the control group, especially in patients with cirrhosis. Furthermore, serum testosterone levels were lower and estrogen levels were higher in cirrhosis cases with Child-Pugh B and C grade compared with Child-Pugh A grade cases. Chronic liver disease patients with secondary gonadal dysfunction are more serious compared with no gonadal dysfunction. This research revealed that thyroid and gonadal dysfunction was present in patients with chronic liver disease, so the determination of thyroid and sex hormone has an important value for the evaluation of severity and prognosis of the disease.