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目的了解男性特发性低促性腺激素性性腺功能减退症(IHH)患者的心理健康状况。方法选取2012年1月—2015年1月在安徽医科大学第一附属医院内分泌科住院诊治的男性IHH患者38例(IHH组),另选取同期在本院体检的健康男性青年20例为对照组。测定两组双侧睾丸容积、阴茎长度、性激素〔卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)〕、血脂〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕、空腹血糖、空腹胰岛素、25羟维生素D等水平,并运用艾森克个性问卷(EPQ)、自卑感量表(FIS)、症状自评量表(SCL-90)评定两组心理健康状况。结果两组年龄、BMI、TC、LDL-C、HDL-C、空腹血糖和25羟维生素D比较,差异均无统计学意义(P>0.05);IHH组睾丸左侧容积、睾丸右侧容积、阴茎长度、FSH、LH、T均低于对照组;TG、空腹胰岛素和胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.05)。EPQ:两组内外向(E)、精神质(P)和掩饰性(L)评分比较,差异无统计学意义(P>0.05);IHH组神经质(N)评分高于对照组(P<0.05)。FIS:两组学习能力评分比较,差异无统计学意义(P>0.05);IHH组自我价值、社交自信、外貌自信、体能自信和FIS量表总分均高于对照组(P<0.05)。SCL-90:IHH组躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性、其他因子评分及总分均高于对照组(P<0.05)。SCL-90总分与N(r=0.844,P<0.001)、P(r=0.733,P=0.003)、自我价值(r=0.748,P=0.002)、社交自信(r=0.551,P=0.041)、外貌自信(r=0.687,P=0.007)呈正相关。多元线性回归分析结果显示,N和自我价值是影响IHH患者心理健康的因素(P<0.05)。结论男性IHH患者心理健康水平低于正常人群,伴有N、自我价值因子评分较高的患者更容易发生心理问题。
Objective To understand the mental health status of idiopathic hypogonadotropic hypogonadism (IHH) in men. Methods From January 2012 to January 2015, 38 IHH patients were enrolled in this study. The IHH patients were enrolled in this study. In the same period, 20 healthy male volunteers were selected as the control group . The testis volume, penis length, sex hormones (follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T)), serum lipids [total cholesterol (TC), triglyceride (TG) (LDL-C, HDL-C), fasting blood glucose, fasting insulin and 25-hydroxyvitamin D were measured with EPQ, FIS), Self-rating Symptom Scale (SCL-90) to assess the mental health of the two groups. Results There were no significant differences in age, BMI, TC, LDL-C, HDL-C, fasting blood glucose and 25-OHG between the two groups (P> 0.05) The penis length, FSH, LH and T were lower than the control group. TG, fasting insulin and insulin resistance index (HOMA-IR) were higher than the control group (P <0.05). There was no significant difference in EPQ between the two groups (P> 0.05). The neurotic score of IHH group was higher than that of control group (P <0.05) ). FIS: There was no significant difference between two groups in learning ability score (P> 0.05). IHH group self-worth, social confidence, appearance self-confidence, physical fitness confidence and FIS scale scores were higher than the control group (P <0.05). SCL-90: The scores of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, psychotic and other factors in IHH group were higher than those in control group (P <0.05). The score of SCL-90 was positively correlated with N (r = 0.844, P <0.001), P (r = 0.733, P = 0.003), self-worth (r = 0.748, P = 0.002) ), Appearance self-confidence (r = 0.687, P = 0.007) was positively correlated. Multivariate linear regression analysis showed that N and self-worth were the factors affecting the mental health of IHH patients (P <0.05). Conclusions The mental health status of male patients with IHH is lower than that of normal people. Patients with high self-worth factor scores are more likely to have psychological problems.