促性腺激素释放激素泵治疗成年男性特发性低促性腺激素性性腺功能减退症的临床疗效与安全性观察

发布时间：2018-06-26 04:58

本文选题：特发性低促性腺激素性性腺功能减退症(IHH) + 脉冲泵　；参考：《中华生殖与避孕杂志》2017年04期

【摘要】：目的探讨促性腺激素释放激素(GnRH)泵治疗成年男性特发性低促性腺激素性性腺功能减退症(IHH)患者的疗效与安全性。方法对确诊为IHH的27例成年男性患者进行GnRH泵脉冲式皮下输注治疗,比较观察患者治疗前后性激素、第二性征、外生殖器、性功能、生育能力的变化情况和不良反应情况。结果平均随访时间13.3(2~38)个月,治疗1年以上18例,6个月~1年2例,3~6个月3例,3个月以下4例。患者治疗前平均睾丸体积(3.38±2.03)mL,阴茎静息长度(3.63±1.10)cm,阴茎牵长(5.73±1.53)cm,阴茎周径(5.13±1.38)cm,黄体生成素(LH)(0.67±0.63)IU/L,卵泡刺激素(FSH)(1.27±0.88)IU/L,睾酮(T)(0.50±0.53)ng/mL;用泵治疗6个月患者睾丸体积(6.48±2.14)mL,阴茎静息长度(4.85±0.83)cm,阴茎牵长(7.90±1.27)cm,阴茎周径(7.27±1.33)cm,LH(6.72±5.35)IU/L,FSH(5.48±3.23)IU/L,T(2.36±1.37)ng/mL,均较治疗前显著提高(P0.01)。用泵治疗1年以上患者睾丸体积(8.78±2.24)mL,阴茎静息长度(5.78±0.75)cm,阴茎牵长(9.31±1.31)cm,阴茎周径(7.94±0.84)cm,LH(6.56±3.89)IU/L,FSH(5.04±2.49)IU/L,T(3.57±1.08)ng/mL,均较治疗前显著提高(P0.01),外生殖器、T较6个月前有显著提高(P0.05)。治疗前25例患者无手淫,无遗精,仅有2例患者有遗精(精液中无精子),治疗6个月以上20例患者均相继出现遗精并伴经常性勃起,其中18例患者取得精液,13例出现精子,2例已婚患者配偶自然妊娠。所有患者治疗期间未见明显不良反应,患者依从性良好。结论 GnRH泵治疗成年男性IHH疗效显著且安全性好,值得临床推广应用。
[Abstract]:Objective to investigate the efficacy and safety of gonadotropin releasing hormone (GnRH) pump in the treatment of adult male idiopathic hypogonadic hypogonadism (IHH). Methods 27 adult male patients with IHH were treated with GnRH pump pulse subcutaneous infusion, and the sex hormone, secondary sex syndrome, and exotropion were observed before and after treatment. The average follow-up time was 13.3 (2~38) months, 18 cases for more than 1 years, 2 cases in 6 months ~1, 3 for 3~6 months and 4 in 3 months. The average volume of testis (3.38 + 2.03) mL before treatment, penile resting length (3.63 1.10) cm, penile stretch (5.73 + 18) cm, penis circumference ( 5.13 + 1.38) cm, luteinizing hormone (LH) (0.67 + 0.63) IU/L, follicle stimulating hormone (1.27 + 0.88) IU/L, testosterone (T) (0.50 + 0.53) ng/mL, and pump for 6 months for patients with testicular volume (6.48 + 2.14) mL, penile resting length (4.85 + 0.83) cm, penile length (0.67) cm, penile circumference cm, LH Ng/mL (+ 1.37) was significantly higher than that before the treatment (P0.01). The volume of testicular (8.78 + 2.24) mL, penile resting length (5.78 + 0.75) cm, penile stretch (9.31 + 1.31) cm, penis circumference (7.94 + 0.84) cm, LH (6.56 + 3.89) IU/L, FSH (5.04 + 3.89) IU/L and T ng/mL, were significantly higher than before treatment. Compared with 6 months ago (P0.05), 25 patients had no masturbation, no spermatogenesis, no spermatogenesis, only 2 patients had spermatozoa (spermatozoa in semen), and 20 patients received spermatozoa and recurrent erectile in 20 cases over 6 months, of which 18 patients obtained semen, 13 had spermatozoa, and 2 married couples had natural pregnancy. All patients were treated in the treatment period. No obvious adverse reactions were observed. The compliance of patients was good. Conclusion GnRH pump is effective and safe in the treatment of adult male IHH. It is worthy of clinical application.
【作者单位】：第三军医大学大坪医院野战外科研究所泌尿外科;
【分类号】：R698

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