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目的:研究中老年男子部分雄激素缺乏(PADAM)采用睾酮补充治疗时,外周血红细胞计数、血球压积、血红蛋白、平均红细胞体积(MCV)、红细胞平均血红蛋白量(MCH)和红细胞平均血红蛋白浓度(MCHC)的变化,进一步观察雄激素补充治疗对促红细胞生成素(EPO)的影响,探讨雄激素促进PADAM男子红细胞和血红蛋白生成增加的机制,对临床上中老年男子使用雄激素治疗有指导意义。方法:27例PADAM男子(54.6+3.2岁),采用口服十一酸睾酮(TU)80mg/d治疗,治疗1、3和6个月随访,治疗前后观察血清性激素水平的变化,查血常规、血球压积、计算MCV、MCH和MCHC,酶免疫方法测定血清EPO。结果:TU治疗3月后,患者PADAM症状改善;治疗1个月后血睾酮水平显著升高,第6个月维持较高的雄激素水平(P<0.05)。TU治疗3个月,血红细胞计数、血球压积和血红蛋白含量的均数均有不同程度的增加,但个体差异较大,统计学上差异不显著(P>0.05)。与治疗前相比,TU治疗1个月时血EPO水平显著升高(P<0.01或0.05),治疗第6个月EPO水平仍然升高(P<0.05),但较治疗1个月时下降。结论:雄激素补充治疗升高PADAM男子血清睾酮水平,改善PADAM症状。雄激素治疗后EPO水平升高,是红细胞生成增加的机制之一,提示老年男子长期使用雄激素补充治疗时应注意对血液系统和血粘度的影响。
Objective: To study the changes of peripheral blood red blood cell count, hematocrit, hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and erythrocyte average hemoglobin concentration (PBC) To investigate the effect of androgen replacement therapy on erythropoietin (EPO) and explore the mechanism of androgen stimulation of the increase of erythrocyte and hemoglobin in PADAM. It is helpful to use androgen therapy in middle-aged and elderly men. Methods: Twenty-seven PADAM men (54.6 + 3.2 years) were treated with oral TU 80 mg / d for 1, 3, and 6 months. Serum levels of sex hormones were observed before and after treatment. Hematocrit, calculate MCV, MCH and MCHC, enzyme immunoassay to measure serum EPO. Results: The symptoms of PADAM were improved after 3 months of TU treatment. The level of serum testosterone was significantly increased after 1 month of treatment and maintained at the 6th month (P <0.05). TU treatment for 3 months, the average number of red blood cell count, hematocrit and hemoglobin increased in varying degrees, but the individual differences were statistically significant (P> 0.05). EPO levels were significantly increased at 1 month of TU treatment (P <0.01 or 0.05) and remained elevated at 6 months of treatment (P <0.05), but decreased at 1 month of treatment . CONCLUSION: Androgen supplementation increases serum testosterone levels in PADAM men and improves symptoms of PADAM. Elevated levels of androgen after androgen therapy is one of the mechanisms of increased erythropoiesis, suggesting that the elderly men should pay attention to the blood system and blood viscosity in the long-term use of androgen replacement therapy.