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目的·通过观察症状性迟发型性腺功能减退(SLOH)合并勃起功能障碍(ED)患者血清生殖激素变化情况,探讨生殖激素与SLOH合并ED(SLOH/ED)的相关关系。方法·采用问卷调查的方式,经整群及年龄分层多阶段不等比例的随机抽样方法,抽取3 000例40~80岁有固定性伴侣的社区中老年男性作为研究对象。采用老年男性症状(AMS)量表评估SLOH及其严重程度,采用国际勃起功能指数问卷表-5(IIEF-5)评估勃起功能,同时检测血清总睾酮(TT)、游离睾酮(FT)、黄体生成素(LH)和性激素结合球蛋白(SHBG)水平,计算生物活性睾酮(Bio-T)水平,单因素和多因素Logistic回归分析生殖激素与SLOH/ED的相关关系。结果·共获得2 588例符合条件的完整研究资料,平均年龄(57.95±8.50)岁。930例(35.94%)男性观察到SLOH(AMS≥27)症状,其中812例(31.38%)男性同时存在ED。739例(28.56%)男性既无SLOH亦不存在ED症状。Logistic回归分析显示TT及FT水平与SLOH/ED的相关关系不明显,年龄、SHBG和Bio-T与SLOH/ED的相关关系有统计学意义(P<0.01)。结论·SHBG和Bio-T与SLOH/ED显著相关,能准确反映SLOH/ED患者的皿清生殖激素水平。
Objective To explore the relationship between reproductive hormones and SLOH combined ED (SLOH / ED) by observing the changes of serum reproductive hormones in patients with symptomatic delayed type hypogonadism (SLOH) and erectile dysfunction (ED). METHODS · A total of 3 000 middle-aged and elderly men aged 40 to 80 years with fixed partners were selected as the study subjects by means of questionnaires and randomized sampling with unequal proportions of stratified and age-stratified groups. The severity of SLOH was assessed using the AMS scale and erectile function was assessed using the International Index of Erectile Function Inventory-5 (IIEF-5). Serum total testosterone (TT), free testosterone (FT), corpus luteum (LH) and sex hormone binding globulin (SHBG) were measured to calculate the level of bioactive T-testosterone. Logistic regression analysis was used to analyze the relationship between reproductive hormones and SLOH / ED. RESULTS · A total of 2 588 eligible studies were completed, with an average age of (57.95 ± 8.50) years. In 930 men (35.94%), symptoms of SLOH (AMS≥27) were observed, of which 812 (31.38%) men also had ED. 739 (28.56%) men had neither SLOH nor ED symptoms. Logistic regression analysis showed that the correlation between TT and FT level and SLOH / ED was not significant, and the correlation between age, SHBG, Bio-T and SLOH / ED was statistically significant (P <0.01). Conclusion · SHBG and Bio-T are significantly correlated with SLOH / ED and accurately reflect the reproductive hormone level in SLOH / ED patients.