雄激素性秃发病人血液流变学指标与血清雄激素水平的关系分析

Analysis of the relationship between hemorheology indexs and serum androgen levels in patients with androgenic alopecia

目的探讨雄激素性秃发病人血液流变学指标与血清雄激素水平的关系。方法选取2019年6月至2021年6月在四川大学华西医院门诊就诊的98例雄激素性秃发病人为观察组,另选取100例健康体检者作为对照组,检测并对比两组的血液流变学指标(包括全血高切、全血中切、全血低切、血浆黏度、血沉、红细胞压积)及血清雄激素水平[包括血清睾丸酮(T)、脱氢异雄酮(DHEA)和双氢睾酮(DHT)]的水平。给予观察组相关治疗,检测并对比治疗前后病人的血液流变学指标。采用Pearson法分析雄激素性秃发病人血液流变学指标与血清雄激素水平的关系。结果对照组中有5例主动撤回知情同意书,观察组中无脱落/剔除病例,最终共纳入对照组95例健康体检者和观察组98例雄激素性秃发病人;观察组全血高、中、低切及红细胞压积均高于对照组[(5.65±0.89)比(3.55±0.57)mPa·s,(7.89±1.04)比(4.85±0.71)mPa·s,(13.35±2.56)比(6.12±1.23)mPa·s,(0.57±0.09)%比(0.45±0.05)%P<0.05];观察组和对照组男性病人T、DHEA及DHT水平均高于女性病人[观察组(574.12±114.21)比(75.23±15.04)ng/dL,(5.35±0.67)比(4.02±0.71)μg/L,(194.35±35.78)比(110.25±20.12)ng/L;对照组(456.45±90.21)比(45.36±9.03)ng/dL,(4.13±0.54)比(2.54±0.45)μg/L,(104.78±25.15)比(68.45±13.78)ng/L,P<0.05];且观察组男性和女性病人的T、DHEA及DHT水平均高于与对照组男性和女性病人(P<0.05);观察组治疗后的全血高切、全血中切、全血低切及红细胞压积均较治疗前降低(P<0.05);Pearson相关性分析发现,雄激素性秃发男性和女性病人全血高切、全血中切、全血低切及红细胞压积与T、DHEA及DHT水平均呈正相关(P<0.05)。结论雄激素性秃发病人血清雄激素水平和血液流变学指标均高于健康人群,且其血液流变学指标与血清雄激素水平呈正相关,提示监测雄激素性秃发病人血液流变学变化对临床诊治具有一定的指导意义。

Objective To investigate the relationship between hemorheology indexs and serum androgen levels in patients with androgenic alopecia.Methods A total of 98 patients with androgenic alopecia who visited the outpatient service of West China Hospital of Sichuan University from June 2019 to June 2021 were selected as the observation group,and 100 healthy people were selected as the control group.The changes of hemorheology indexs(including whole blood high shear,whole blood middle shear,whole blood low shear,plasma viscosity,erythrocyte sedimentation rate,hematocrit)and serum androgen levels[including serum testosterone(T),dehydroepiandrosterone(DHEA)and dihydrotestosterone(DHT)]were detected and compared between the two groups.The observation group was given relevant treatment,and the hemorheological indexes of patients before and after treatment were detected and compared.Pearson method was used to analyze the relationship between hemorheology indexs and serum androgen levels in patients with androgenic alopecia.Results Five cases in the control group voluntarily withdrew their informed consent forms,and there were no dropout/exclusion cases in the observation group.Finally,a total of 95 healthy individuals in the control group and 98 patients with androgenic alopecia in the observation group were included.The whole blood high cut,whole blood middle cut,whole blood low cut and hematocrit in the observation group were higher than those in the control group[(5.65±0.89)vs.(3.55±0.57)mPa·s,(7.89±1.04)vs.(4.85±0.71)mPa·s,(13.35±2.56)vs.(6.12±1.23)mPa·s,(0.57±0.09)%vs.(0.45±0.05)%](P<0.05).The levels of T,DHEA and DHT in male patients in the observation group and control group were higher than those in female patients[observation group(574.12±114.21)vs.(75.23±15.04)ng/dL,(5.35±0.67)vs.(4.02±0.71)μg/L,(194.35±35.78)vs.(110.25±20.12)ng/L.control group(456.45±90.21)vs.(45.36±9.03)ng/dL,(4.13±0.54)vs.(2.54±0.45)μg/L,(104.78±25.15)vs.(68.45±13.78)ng/L,P<0.05],and the levels of T,DHEA and DHT in male and female patients in the observation group were higher than those in male and female patients in the control group(P<0.05). The whole blood high cut, whole blood middle cut, whole blood low cut and hematocrit in the observation group after treatmentwere lower than those before treatment (P< 0.05). Pearson correlation analysis showed that the levels of T, DHEA and DHT were positivelycorrelated with whole blood high cut, whole blood middle cut, whole blood low cut and hematocrit in male and female patientswith androgenic alopecia (P< 0.05).Conclusion The levels of serum androgen and hemorheological indexes in patients with androgenicalopecia are higher than those in healthy people, and their hemorheological indexes are positively correlated with the levels of serumandrogen, suggesting that monitoring the changes of hemorheology in patients with androgenic alopecia has certain guiding significancefor clinical diagnosis and treatment.