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目的了解老年男性心力衰竭(心衰)患者性激素水平及与心功能之间的关系。方法临床诊断为慢性心衰的男性住院患者共100例,年龄在60~87(70.35±8.63)岁,超声心动图检查左室射血分数≤0·45,同时观察健康老年男性400例[(71.25±6.81)岁]作为正常对照。采集其晨起静脉血,低温离心后取血清,测定总睾酮、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇、黄体生成素(LH)、卵泡刺激素(FSH)水平,并在同龄心衰患者及健康男性之间进行比较。结果(1)心衰患者DHEAS水平随着年龄的增加降低(P<0.05),而SHBG、LH、FSH水平则随着年龄的增加而增加(P<0.05,P<0.01)。(2)与同龄健康男性相比,心衰患者总睾酮、FT、雌二醇、DHEAS明显降低(P<0.01),LH、FSH差异无统计学意义。SHBG水平显著增加(P<0.01)。(3)FT水平与左室射血分数呈显著正相关(r=0.279,P=0.034)。结论老年男性心衰患者的雄激素水平显著降低,且FT水平与心衰程度呈负相关。
Objective To investigate the relationship between sex hormone levels and cardiac function in elderly male patients with heart failure (heart failure). Methods A total of 100 male inpatients with chronic heart failure were enrolled in this study. Their age ranged from 60 to 87 (70.35 ± 8.63) years. Echocardiography was used to examine left ventricular ejection fraction ≤0.45. In addition, 400 healthy elderly men [ 71.25 ± 6.81) years old as a normal control. The blood samples were taken from the morning and then collected at low temperature. The total testosterone, free testosterone (FT), DHEAS, SHBG, estradiol and luteinizing hormone LH), follicle-stimulating hormone (FSH) levels were compared between healthy-heart and male patients of the same age. Results (1) The levels of DHEAS in patients with heart failure decreased with age (P <0.05), while the levels of SHBG, LH and FSH increased with age (P <0.05, P <0.01). (2) The total testosterone, FT, estradiol and DHEAS in patients with heart failure were significantly lower than those in healthy men (P <0.01), while there was no significant difference between LH and FSH. SHBG levels increased significantly (P <0.01). (3) There was a significant positive correlation between FT level and left ventricular ejection fraction (r = 0.279, P = 0.034). Conclusion The level of androgen in elderly male patients with heart failure is significantly decreased, and the level of FT is negatively correlated with the degree of heart failure.