本文關鍵詞： 睪酮 雄激素類 中年人 老年人 男人 性腺功能減退癥 老年男性癥狀量表　出處：《中國全科醫(yī)學》2017年33期 　論文類型：期刊論文

【摘要】：目的探討老年男性癥狀量表(AMS)評分預測社區(qū)中老年男性血清睪酮相關指標[總睪酮(TT)、性激素結合球蛋白(SHBG)、黃體生成素(LH)、游離睪酮(cFT)、游離睪酮指數(shù)(FTI)、睪酮分泌指數(shù)(TSI)]異常的價值,以期為臨床篩查和診斷遲發(fā)性性腺功能減退癥(LOH)提供參考依據。方法根據遵義市的經濟特征和生活方式,將社區(qū)分為城市、城鎮(zhèn)、鄉(xiāng)村3個層次,于2013年8—9月,采用分層整群抽樣方法以1∶10的比例從每層中隨機抽取7個社區(qū)/居委會/村作為抽樣點。選取抽樣點20歲及以上男性為調查對象,共收集到1 166份合格數(shù)據。以227例20~39歲居民的血清睪酮相關指標水平來確立男性血清睪酮相關指標異常切點值,采用939例40歲及以上居民的數(shù)據評價AMS評分預測血清睪酮相關指標異常的價值。采用自制調查問卷對居民進行調查,調查內容包括基本情況、家族史、既往史、AMS評分(設定AMS評分27分為無LOH癥狀,≥27分為有LOH癥狀)。檢測居民血清TT、SHBG、LH,計算cFT、FTI、TSI。結果 939例40歲及以上居民中,有LOH癥狀628例(66.9%),TT異常36例(3.8%,其中有LOH癥狀25例),SHBG異常203例(21.6%,其中有LOH癥狀155例),LH異常57例(6.1%,其中有LOH癥狀53例),cFT異常136例(14.5%,其中有LOH癥狀110例),FTI異常271例(28.9%,其中有LOH癥狀213例),TSI異常249例(26.5%,其中有LOH癥狀200例)。有LOH癥狀與無LOH癥狀居民TT比較,差異無統(tǒng)計學意義(P0.05);有LOH癥狀居民SHBG、LH高于無LOH癥狀居民,cFT、FTI、TSI低于無LOH癥狀居民(P0.05)。有LOH癥狀與無LOH癥狀居民TT異常率比較,差異無統(tǒng)計學意義(P0.05);有LOH癥狀居民SHBG、LH、cFT、FTI、TSI異常率大于無LOH癥狀居民(P0.05)。以AMS評分27分為臨界值,AMS評分預測TT異常的總符合率較低,為34.61%,預測FTI、TSI異常的總符合率較高,分別為49.63%、49.20%。AMS評分預測TT異常的Kappa值為0.003,P=0.739;AMS評分預測SHBG、LH、cFT、FTI、TSI異常的Kappa值分別為0.069、0.049、0.065、0.118、0.123,P值均0.01。結論 AMS評分預測TT異常的價值較差,預測FTI、TSI異常的價值較好。
[Abstract]:Objective to explore the value of AMS-score in predicting serum testosterone related indexes [total testosterone TTT, sex hormone binding globulin SHBGG, luteinizing hormone LHN, free testosterone cFTI, free testosterone index FTI, testosterone secretion index TSIs] in elderly men in the community. Methods according to the economic characteristics and lifestyle of Zunyi, the community was divided into three levels: urban, urban and rural. A stratified cluster sampling method was used to randomly select 7 communities / neighborhood committees / villages from each floor at 1:10. Men aged 20 years and above were selected as sampling points. A total of 1 166 eligible data were collected to determine the abnormal cut point of male serum testosterone related indexes based on the serum testosterone levels of 227 residents aged 20 to 39 years old. The data of 939 residents aged 40 and above were used to evaluate the value of AMS score in predicting the abnormal serum testosterone. A self-made questionnaire was used to investigate the residents, including the basic situation and family history. Past history AMS score (set up AMS score 27 as no LOH symptom, 鈮，

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