老年男性症状量表评分预测社区中老年男性血清睾酮相关指标异常的价值研究

发布时间：2018-02-09 06:29

  本文关键词： 睾酮 雄激素类 中年人 老年人 男人 性腺功能减退症 老年男性症状量表　出处：《中国全科医学》2017年33期 　论文类型：期刊论文

【摘要】：目的探讨老年男性症状量表(AMS)评分预测社区中老年男性血清睾酮相关指标[总睾酮(TT)、性激素结合球蛋白(SHBG)、黄体生成素(LH)、游离睾酮(cFT)、游离睾酮指数(FTI)、睾酮分泌指数(TSI)]异常的价值,以期为临床筛查和诊断迟发性性腺功能减退症(LOH)提供参考依据。方法根据遵义市的经济特征和生活方式,将社区分为城市、城镇、乡村3个层次,于2013年8—9月,采用分层整群抽样方法以1∶10的比例从每层中随机抽取7个社区/居委会/村作为抽样点。选取抽样点20岁及以上男性为调查对象,共收集到1 166份合格数据。以227例20~39岁居民的血清睾酮相关指标水平来确立男性血清睾酮相关指标异常切点值,采用939例40岁及以上居民的数据评价AMS评分预测血清睾酮相关指标异常的价值。采用自制调查问卷对居民进行调查,调查内容包括基本情况、家族史、既往史、AMS评分(设定AMS评分27分为无LOH症状,≥27分为有LOH症状)。检测居民血清TT、SHBG、LH,计算cFT、FTI、TSI。结果 939例40岁及以上居民中,有LOH症状628例(66.9%),TT异常36例(3.8%,其中有LOH症状25例),SHBG异常203例(21.6%,其中有LOH症状155例),LH异常57例(6.1%,其中有LOH症状53例),cFT异常136例(14.5%,其中有LOH症状110例),FTI异常271例(28.9%,其中有LOH症状213例),TSI异常249例(26.5%,其中有LOH症状200例)。有LOH症状与无LOH症状居民TT比较,差异无统计学意义(P0.05);有LOH症状居民SHBG、LH高于无LOH症状居民,cFT、FTI、TSI低于无LOH症状居民(P0.05)。有LOH症状与无LOH症状居民TT异常率比较,差异无统计学意义(P0.05);有LOH症状居民SHBG、LH、cFT、FTI、TSI异常率大于无LOH症状居民(P0.05)。以AMS评分27分为临界值,AMS评分预测TT异常的总符合率较低,为34.61%,预测FTI、TSI异常的总符合率较高,分别为49.63%、49.20%。AMS评分预测TT异常的Kappa值为0.003,P=0.739;AMS评分预测SHBG、LH、cFT、FTI、TSI异常的Kappa值分别为0.069、0.049、0.065、0.118、0.123,P值均0.01。结论 AMS评分预测TT异常的价值较差,预测FTI、TSI异常的价值较好。
[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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