个体化睾酮替代疗法治疗男性迟发性性腺功能减退症患者对血清总睾酮和性激素水平的影响

Effect of individualized testosterone replacement therapy on serum total testosterone and sex hormone levels in male patients with late-onset hypogonadism

目的探讨个体化睾酮替代疗法治疗男性迟发性性腺功能减退症(Late-onset Hypogonadism,LOH)患者对血清总睾酮和性激素水平的影响。方法选择2015年7月~2019年1月中我院男科门诊收治的80例男性迟发性性腺功能减退症患者作为本次研究样本,按照血清总睾酮(testosterone,TT)的水平差异将其分为1组(TT<8 ng/dL)与2组(8≤TT<11.5 ng/dL),再将2组按不同给药剂量分为a组、b组,给予三组个体化睾酮替代疗法,连续服用十一酸睾酮3个月(1个疗程),观察对比三组治疗后的临床效果。结果治疗后三组的SHBG水平均明显低于治疗前(P<0.05);而三组治疗后的血清TT水平均明显高于治疗前,a组的血清TT水平明显高于b组(P<0.05);三组治疗后的E2、FSH水平均明显低于治疗前(P<0.05),P水平明显高于治疗前(P<0.05);三组治疗后的ADAM评分情况均明显优于治疗前(P<0.05)。结论建议血清TT水平在<8 ng/dL范围的LOH患者常规服用十一酸睾酮,血清TT水平在8≤TT<11.5 ng/dL范围的LOH患者服用小剂量十一酸睾酮补充治疗,方可达到最佳疗效。

Objective To analyze the effect of individualized testosterone replacement therapy on serum total testosterone and sex hormone levels in patients with late-onset hypogonadism(LOH). Methods A total of 80 patients with late-onset hypogonadism in the men's outpatient department of our hospital from July 2015 to January 2019 were selected as samples of this study. According to the difference of serum testosterone(TT) levels, the patients were divided into group 1(TT<8 ng/dL) and group 2(8≤TT<11.5 ng/dL), and then the group 2 was divided into group a and group b according to different doses. Three groups were given individualized testosterone replacement therapy and given continuous administration of testosterone undecanoate for 3 months(1 course of treatment). The clinical effect of the three groups after treatment was observed. Results After treatment, the levels of SHBG in the three groups were significantly lower than those before treatment(P<0.05). The serum TT levels in the three groups after treatment were significantly higher than those before treatment. The serum TT level in group a was significantly higher than that in group b(P<0.05). The levels of E2 and FSH in the three groups after treatment were significantly lower than those before treatment(P<0.05), and the P level in the three groups after treatment was significantly higher than before treatment(P<0.05). The ADAM scores of the three groups after treatment were significantly better than those before treatment(P<0.05). Conclusion It is recommended that LOH patients with serum TT levels in the range of <8 ng/dl should be routinely taken testosterone undecanoate, and LOH patients with serum TT levels ranging from 8≤TT<11.5 ng/dL should be treated with small doses of testosterone undecanoate, which can achieve the best effect.