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目的 :观察雄激素替代治疗对性腺功能低减男子促红细胞生成素 (EPO)的影响 ,探讨雄激素促进红细胞和血红蛋白生成增加的机制。 方法 :8例原发性性腺功能低减 (Klinefelter综合征 )病人 ,接受初次 5 0 0mg或10 0 0mg十一酸睾酮 (TU)肌肉注射 ,间隔 3个月后交叉剂量第二次注射。注射前后观察血清性激素水平的变化 (放免法 ) ;在注射前和后的第 4、8周分别查血常规和红细胞比容 ,酶免疫法测定血清EPO。 结果 :注射TU后 ,第二性征发育情况改善 ,血睾酮水平显著升高 ,注射后 1周达峰值 ,维持有效治疗的雄激素水平 (>10nmol/L)超过 6周。血红细胞计数、红细胞比容和血红蛋白含量的均数均有不同程度的增加趋势 ,但统计学上差异不显著 (P >0 .0 5 )。与治疗前相比 ,注射TU后EPO水平显著升高 ,并维持 8周以上 (P <0 .0 1～ 0 .0 5 ) ;第 2次注射TU仍然使EPO水平升高。 结论 :雄激素替代治疗使性腺功能低减男子EPO水平升高 ,是红细胞生成增加的机制之一。
Objective: To observe the effect of androgen replacement therapy on the level of erythropoietin (EPO) in male patients with hypogonadism and to explore the mechanism of androgen to promote the production of erythrocyte and hemoglobin. Methods: Eight patients with primary hypogonadism (Klinefelter’s syndrome) received intramuscular injection of 500 mg or 100 mg of testosterone undecanoate for the first time, followed by a second dose of crossover dose after 3 months. Changes of serum sex hormone levels were observed before and after injection (radioimmunoassay). Blood routine and hematocrit were measured at the 4th and 8th weeks before and after injection, and serum EPO was measured by enzyme immunoassay. RESULTS: After TU injection, the development of secondary sexual characteristics improved and the level of serum testosterone increased significantly. The peak value reached the first week after injection, and the level of androgen (> 10 nmol / L) remained effective for more than 6 weeks. The average number of hematocrit, hematocrit and hemoglobin increased with different degrees, but the difference was not statistically significant (P> 0.05). Compared with those before treatment, the levels of EPO increased significantly after TU injection for more than 8 weeks (P <0.01 ~ 0.05); the second injection of TU still increased the level of EPO. CONCLUSIONS: Androgen replacement therapy elevates EPO levels in men with hypogonadism and is one of the mechanisms of increased erythropoiesis.