勃起功能障碍同病异证患者血清性激素水平及其与常见临床参数关系的研究

Expression of sexual hormones in erectile dysfunction with different syndromes and their association with clinical Parameters

目的探讨维吾尔医学(维医)异常胆液质型(ASap)勃起功能障碍(ED)、异常血液质型ED(AKanED)、异常黏液质型ED(APhl-ED)、异常黑胆质型ED(ASav-ED)患者血清性激素水平及其与常见临床参数的关系。方法在维医体液辨证分型的基础上选取国际勃起功能指数5项(IIEF-5)评分<22分的阳痿患者77例,其中38例APhl-ED患者(APhl-ED组)、15例ASav-ED患者(ASav-ED组)、13例AKan-ED患者(AKan-ED组)、11例ASap-ED患者(ASap-ED组)和21例正常健康人(N组),收集常见临床资料,采用电化学发光免疫分析法检测血清性激素水平,并分析其与常见临床参数的关系。结果APhl-ED组睾酮(T)水平显著降低(P<0.05),AKan-ED和APhl-ED组雌二醇(E2)水平均显著增高(P<0.05),ASap-ED、AKan-ED、APhl-ED和ASav-ED组促黄体生成素(LH)水平显著增高(P<0.05),APhl-ED和ASav-ED组催乳素(PRL)水平显著增高(P<0.05),ASav-ED组卵泡刺激素(FSH)显著增高(P<0.05)。性激素水平与常见临床参数分析发现,在年龄≥40y、腰围≥90cm、IIEF-5<12分、MSF-4<9分的ED患者血清中T水平显著降低(P<0.05);IIEF-5<12分、MSF-4评分<9分的ED患者血清中E2和LH水平均显著增高(P<0.05)。结论性腺轴功能改变在ED发生、发展过程中发挥着关键性的作用,为不同证型ED的共性机制之一,而其具体的内分泌改变则因证型不同可能有所差异。

Objective To study the expression of sexual hormones in ED with different syndromes （abnor-mal phlegmatic, abnormal savda, abnormal sapra and abnormal kan） of Uyghur medicine and their associ-ation with clinicopathogical parameters. Methods On the basis of syndrome differentiation of Uygur Med-icine, 77 cases of impotence patients with the international erectile function index 5 （IIEF-5） score〈22 were selected, including 38 APhl-ED, 15 ASav-ED, 11 ASap-ED, 13 AKan-ED patients and 21 normal healthy persons （N group）. The clinical data were collected and the serum sex hormones were detected by electrochemiluminescence immunoassay, and the relationship between the sex hormones and the clinical parameters was analyzed. Results Testosterone （ T ） level reduced in APhl-ED group （P〈 0.05） , Estradiol （E2） level increased in APhl-ED and AKan-ED group （P 〈0.05） ; Luteinizing hormone （LH） level increased in ASap-ED, AKan-ED, APhl-ED and ASav-ED group （P 〈0.05）; Prolactin （PRL） level increased in APhl-ED and ASav-ED group （P 〈0.05） ; FSH level increased in ASav-ED group （P〈0.05）. T level dereased in patients with age≥4 0y , waist≥90 cm, IIEF-5〈2 and MSF-4〈9（P〈0.05） ; E2 and LH level significantly increased in patients with IIEF-5〈12 and MSF-4〈9 （ P〈0.05）. Conclusion Neu-roendocrine disorder, especially the function of gonad axis changes in ED development plays a key role, as one of the common mechanism of different syndrome types of ED, and its specific endocrine change due to different syndromes may vary. Clinical pathological parameters change of ED patients with different syn-drome not only accords with theory of Uyghur body fluids, also are important factors of different syn-dromes of ED.