摘要
前列腺生长依赖雄激素的理论使得临床上担忧补充睾酮可能会增加前列腺体积进而恶化下尿路症状(LUTS),但越来越多的研究表明睾酮补充治疗(TST)不会增大迟发性性腺功能减退综合征(LOH)患者的前列腺体积,不影响IPSS,这可能与前列腺上雄激素受体的饱和程度有关。睾酮缺乏(TD)和代谢综合征(Mets)是LUTS的危险因素,TD可能通过影响自主神经功能、膀胱和尿道平滑肌的舒张与供血,Rho酶活性进而影响LUTS;Mets的存在增强交感神经活动,引起机体炎性状态,造成动脉硬化也会增加LUTS发生的风险。研究证实TST可以改善LOH患者的LUTS,而且患者的基线IPSS越高,患者伴有Mets,TST改善LUTS效果可能越好。未来,需要更多的研究来证实TST改善LUTS的作用。
The theory that prostate growth depends on androgens has caused the worry clinically that the testosterone supplementation therapy(TST) may increase the prostate volume and worsen lower urinary tract symptoms(LUTS). However, more and more findings show that TST does not increase the prostate volume in patients with late-onset hypogonadism(LOH) or affect the IPSS, which may be attributed to the saturation of the androgen receptor. Testosterone deficiency and metabolic syndrome are risk factors for LUTS, the former affecting the autonomic nerve function, relaxation and blood supply of the bladder and urethral smooth muscle, and Rho enzyme activity, while the latter enhancing sympathetic activity and causing the body’s inflammatory state and arteriosclerosis. Findings have proved that TST can improve LUTS in patients with LOH, with even better effect in those with a higher baseline IPSS or metabolic syndrome. More researches are needed to confirm the role of TST in improving LUTS.
作者
张志超
彭靖
ZHANG Zhi-chao;PENG Jing(Center of Andrology,Peking University First Hospital,Beijing 100034,China)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2020年第5期387-391,共5页
National Journal of Andrology
关键词
迟发性性腺功能减退综合征
睾酮缺乏
睾酮补充疗法
前列腺
下尿路症状
代谢综合征
late-onset hypogonadism
testosterone deficiency
testosterone supplementation therapy
prostate
lower urinary tract symptom
metabolic syndrome
