227例成人47，XXY患者临床特点及激素水平相关性分析

Clinical features and sex hormone parameters analysis in 227 male patients with 47, XXY

目的探讨Klinefelter综合征（克氏征）患者（47，XXY）的临床特点。方法回顾性分析227例接受供精人工授精（artificial insemination with donor，AID）治疗的47，XXY患者临床资料包括年龄、学历、身高、体重、体重指数；FSH、LH、睾酮、催乳素、雌二醇。结果这些患者身高（176．4±5．5）cm、体重（74．5±12．7）kg、体重指数（23．89±3．66）kg／m^2，超重者77例（33．92％），肥胖者34例（14．98％）。性激素FSH（38．35±14．33）IU／L，LH（19．40±9．oo）IU／L，睾酮（132．00±194．50）ng／dl，雌二醇（23．90±15．00）ng／L，催乳素（10．50±8．20）μg／L，雌二醇／睾酮0．21±0．80；睾丸体积与雄激素水平呈正相关（r=0．197，P=0．003）；体重指数与雄激素水平呈负相关（r=-0．284，P=0．000），与雌激素呈正相关（r=0．174，P=0．009）；与雌二醇／睾酮呈正相关（r=0．323，P=0．000）。年龄与睾酮、雌二醇、雌二醇／睾酮之间无相关性（P〉0．05）；与LH之间呈负相关关系（r=-0．154，P=0．02），与FSH之间呈负相关关系（r=-0．196，P=0．03）。高学历组平均年龄高于低学历组（P〈0．01），雄激素水平低于低学历组（P〈0．01）。结论克氏征患者（47，XXY）睾酮与患者睾丸体积密切相关；克氏征患者睾酮、雌二醇和雌二醇／睾酮与患者身高、体重指数、文化程度相关。

Objective To explore clinical characteristics of patients with Klinefeher＇s syndrome （ KS ; 47, XXY）. Methods 227 male patients with 47, XXY treated by artificial insemination with donor （ AID ） were included. Age, education, height, weight, body mass index（ BMI）, testicular volume, FSH, LH, testosterone（ T）, prolactin（ PRL）, estradiol（ E2 ） were analyzed retrospectively. Results Of these patients, their height were （ 176.4 ± 5.5 ） cm, weight （ 74.5 ± 12.7 ） kg, BMI （ 23.89 ± 3.66 ） kg/m2 [ 77 of overweight （ 33.92% ） and 34 of obesity （ 14.98% ） ], FSH （ 38.35 ± 14.33 ） IU/L, LH （ 19.40 ± 9.00） IU/L, T （ 132.00 ± 194.50 ） ng/dl, E2 （ 23.90 ± 15.00） ng/L, PRL （ 10.50 ± 8.20） μg/L, E2/T 0.21 ± 0.80. Testicular volume had the positive association with the level of T（ r = 0. 197, P = 0.003 ）. BMI had the negative association with the serum concentration of T（ r =-0. 284, P=0.000） , while positive association with the E2 （ r = 0. 174, P = 0. 009 ） and ratio of E2/T （ r = 0. 323, P=0.000）. Age had no association with T, E2, and E2/T （ P〉0.05 ） , but had negative association with the serum concentration of LH （ r = -0.154, P = 0.02 ） and FSH （ r = -0.196, P = 0.03 ）. The higher education group were older （ P〈0.01 ）, while the level of T were lower（ P〈0.01 ）. Conclusion In patients with Klinefeher＇s syndrome （ KS ; 47, XXY）, level of T may associate with testicular volume. T, E2, and the ratio of E2/T seem to associate with their height, BMI, and education level.