摘要
目的:通过观察勃起功能障碍(ED)患者中血清计算游离睾酮(cFT)、睾酮分泌指数(TSI)及游离睾酮指数(FTI)的变化情况,探讨cFT、TSI、FTI在ED伴雄激素缺乏诊断中的价值。方法:详细询问病史,填写国际勃起功能指数问卷(IIEF-5),完成夜间阴茎勃起功能检测(NPT),根据病史及NPT检查结果纳入实验组及对照组,检测150例NPT结果异常以"ED"为主诉的ED患者及25例NPT结果正常的健康婚检者中血清总睾酮(TT)、黄体生成素(LH)、性激素结合球蛋白(SHBG)和血清白蛋白(ALB),通过公式计算cFT、生物可利用睾酮(Bio-T)、TSI、FTI。以cFT≤0.3 nmol/L、TSI≤2.8、FTI≤0.4为参考截点值,以TT≤11.5 nmol/L为诊断雄激素缺乏的标准,计算出cFT、TSI、FTI的漏诊率、误诊率及符合率。结果:以TT≤11.5 nmol/L为评估标准,诊断20~40岁ED患者雄激素缺乏的符合率分别为cFT 90.8%、TSI 85.8%、FTI 80.8%;诊断20~40岁ED患者雄激素缺乏的漏诊率分别为cFT 4.0%、TSI 33.3%、FTI 44.0%;诊断20~40岁ED患者雄激素缺乏的误诊率分别为cFT 10.5%、TSI9.4%、FTI 12.6%。Kappa值分别为:cFT 0.755、TSI 0.564、FTI 0.427,P均<0.05。TT在不同年龄组ED患者中随年龄下降但无统计学差异,cFT、Bio-T、TSI、FTI在不同年龄组ED患者中随年龄下降且具有统计学差异;20~40岁ED患者血清TT、cFT、Bio-T、TSI、FTI在不同IIEF评分组的差别无统计学差异。结论:cFT对20~40岁ED患者伴有雄激素缺乏的检测价值优于TT、TSI及FTI。
Objective： To investigate the values of serum calculated free testosterone （cFT）, testosterone secretion index （TSI）, and free testosterone index （FTI） in the diagnosis of ED with androgen deficiency by observing their changes in the patient. Methods： We conducted this study among 185 men complaining of ED and 35 20 -40 years old healthy males presenting at the clinic for premarital medical checkup. We asked them about their medical hist to fill in the International Index of Erectile Function （IIEF-5） Questionnaire, and to complete the nocturnal penile tumescence （NPT） test. According to the data obtained, 150 of the complainants were diagnosed as ED patients and 25 of the healthy examinees were included in the control group. We determined the levels of total serum testosterone （TT）, luteinizing hormone （LH）, sex hormone-binding globulin （SHBG）, serum albumin （ALB）,cFT, bio-available testosterone （bio-T）, TSI, and FTI in the two groups of subjects. Using cFT ≤0.3 nmol/L, TSI ≤2.8, and FTI ≤0.4 as the critical values and TT ≤ 11.5 nmol/L as the gold standard for androgen deficiency, we calculated cFT-, TSI-, and FTI- related rates of missed diagnosis, misdiagnosis, and diagnostic coincidence. Results ： With TF ≤ 11.5 nmol/L as the criterion, the cFT-, TSI-, and FTI-related rates of coincidence in the diagnosis of androgen deficiency in the ED patients were 90.8% , 85.8% , and 80.8% , those of missed diagnosis were 4.0% , 33.3% , and 44.0% , and those of misdiagnosis were 10.5% , 19.4% , and 12.6% , with the Kappa of values 0. 755, 0.564, and 0.427, respectively （P 〈 0.05）. The levels of serum TT, cFT, Bio-T, TSI, and FTI were decreased with increased age of the 20 -40 years old ED patients, with statistically significant differences among different age groups except the serum TF level. However, no statistically significant differences were found in the levels of TF, cFT, Bio-T, TSI, and among the patients with different IIEF-5 scores. Conclusion ： The
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2017年第9期808-812,共5页
National Journal of Andrology
基金
广东省自然科学基金(2015A030313730)~~
关键词
勃起功能障碍
游离睾酮
睾酬分泌指数
游离睾酮指数
erectile dysfunction
free testosterone
testosterone secretion index
free testosterone index
