目的 了解十一酸睪酮在改善老年男性慢性疾病晚期患者生存質(zhì)量和體力改善方面的作用及其安全性和耐受性.
方法 采用前瞻性隨機(jī)對(duì)照設(shè)計(jì)方案,將2003年6月至2005年3月在四川大學(xué)華西醫(yī)院老年科住院的80名慢性疾病晚期伴衰竭的老年男性患者隨機(jī)(采用簡(jiǎn)單隨機(jī)法)分成兩組.試驗(yàn)組在常規(guī)臨床支持治療基礎(chǔ)上加服十一酸睪酮;對(duì)照組僅采用常規(guī)臨床治療.觀察各項(xiàng)相關(guān)指標(biāo)的變化.
結(jié)果 ①兩組基線情況有可比性; ②治療組較對(duì)照組更年期相關(guān)癥狀評(píng)分下降,生活質(zhì)量評(píng)分增加(P＜0.05); ③與對(duì)照組相比,試驗(yàn)組血清總睪酮水平明顯增加,上臂周徑及右手握力增加(P＜0.05);體重、BMI及左手握力雖有增加,但與對(duì)照組比較無明顯差異(P＞0.05); ④治療后尿路癥狀、下肢水腫、血前列腺特異抗原、肝功、血糖及血色素水平,兩組無明顯差異.
結(jié)論 十一酸睪酮能明顯改善老年男性慢性疾病衰竭患者整體臨床狀況,使患者血清睪酮水平增加,并具有良好的安全性和耐受性.
引用本文： 舒德芬,董碧蓉. 十一酸睪酮改善慢性疾病晚期老年男性患者生存質(zhì)量的隨機(jī)對(duì)照試驗(yàn). 中國(guó)循證醫(yī)學(xué)雜志, 2005, 05(8): 599-604. doi: 復(fù)制
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| 3. | Gray A, Feldman HA, Mckinlay JB, Longcope C. Age, disease and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study[J]. J Clin Endocrinol Metab, 1991; 73(5): 1016-1025. |
| 4. | Barrett-connor E, Von Mühlen DG, Kritz-silverstein D. Bioavaolable testosterone and depressed mood in older men: The Rancho Bernardo Study[J]. J Clin Endocrinol Metab, 1999; 84(2): 573-577. |
| 5. | Wang C, Swerdloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, Matsumoto AM, Weber T, Berman N. The Testosterone Gel Study Group, Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. Testosterone Gel Study Group[J]. J Clin Endocrinol Metab, 2000; 85(8): 2839-2853. |
| 6. | Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Lenrow DA, Holmes JH, Dlewati A, Santanna J, Rosen CJ, Strom BL. Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age[J]. J Clin Endocrinol Metab, 1999; 84(8): 2647-2653. |
| 7. | Wittert GA, Chapman IM, Haren MT, Mackintosh S, Coates P, Morley JE. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status[J]. ournals of Gerontology Series A-Biological Sciences & Medical Sciences, 2003; 58(7): 618-625. |
| 8. | Storer TW, Magliano L, Woodhouse L, Lee ML, Dzekov C, Dzekov J, Casaburi R, Bhasin S. Testosterone dose-dependently increases maximal voluntary strength and leg power, but does not affect fatigability or specific tension[J]. J Clin Endocrinol Metabo, 2003; 88(4): 1478-1485. |
| 9. | Pope HG Jr, Cohane GH, Kanayama G, Siegel AJ, Hudson JI. Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial[J]. Am J Psychiatry, 2003; 160(1): 105-111. |
| 10. | Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging[J]. Urology, 2004; 63(4): 641-646. |
| 11. | Leibenluft E, Schmidt PJ, Turner EH, Danaceau MA, Ashman SB, Wehr TA, Rubinow DR. Effects of leuprolide-induced hypogonadism and testosterone replacement on sleep, melatonin, and prolactin secretion in men[J]. J Clin Endocrinol Metab, 1997; 82(10): 3203-3207. |
| 12. | Ly LP, Jimenez M, Zhuang TN, Celermajer DS, Conway AJ, Handelsman DJ. A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency[J]. J Clin Endocrinol Metab, 2001; 86(9): 4078-4088. |
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| 14. | Park NC, Yan BQ, Chung JM, Lee KM. Oral testosterone undecanoate (Andriol) supplement therapy improves the quality of life for men with testosterone deficiency[J]. Aging Male, 2003; 6(2): 86-93. |
| 15. | Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ. The short-term effects of high-dose testosterone on sleep, breathing, and function in older men[J]. J Clin Endocrinol Metab, 2003; 88(8): 3605-3613. |
| 16. | Huang ZM, Han YF, Li Z. The study of whether testosterone supplement therapy improving the risk of benign prostatic hyperplasia[J]. Chinese Male Science Journal, 2002; 16(5): 364-366, 369. |
| 17. | Behre HM, Bohmeyer J, Nieschlag E. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls[J]. Clin Endocrinol (Oxf), 1994; 40(3): 341-349. |
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- 1. 黃志明, 韓銀發(fā), 李錚. 睪酮補(bǔ)充治療是否增加患者良性前列腺增生風(fēng)險(xiǎn)的研究[J]. 中國(guó)男科學(xué)雜志, 2002; 16(5): 364～366, 369.
- 2. Ferrini RL, Barrett-Connor E. Sex hormones and age: a cross-sectional study of testosterone and estradiol and their bioavailable fractions in community-dwelling men[J]. Am J Epidemio, 1998; 147(8): 750-754.
- 3. Gray A, Feldman HA, Mckinlay JB, Longcope C. Age, disease and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study[J]. J Clin Endocrinol Metab, 1991; 73(5): 1016-1025.
- 4. Barrett-connor E, Von Mühlen DG, Kritz-silverstein D. Bioavaolable testosterone and depressed mood in older men: The Rancho Bernardo Study[J]. J Clin Endocrinol Metab, 1999; 84(2): 573-577.
- 5. Wang C, Swerdloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, Matsumoto AM, Weber T, Berman N. The Testosterone Gel Study Group, Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. Testosterone Gel Study Group[J]. J Clin Endocrinol Metab, 2000; 85(8): 2839-2853.
- 6. Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Lenrow DA, Holmes JH, Dlewati A, Santanna J, Rosen CJ, Strom BL. Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age[J]. J Clin Endocrinol Metab, 1999; 84(8): 2647-2653.
- 7. Wittert GA, Chapman IM, Haren MT, Mackintosh S, Coates P, Morley JE. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status[J]. ournals of Gerontology Series A-Biological Sciences & Medical Sciences, 2003; 58(7): 618-625.
- 8. Storer TW, Magliano L, Woodhouse L, Lee ML, Dzekov C, Dzekov J, Casaburi R, Bhasin S. Testosterone dose-dependently increases maximal voluntary strength and leg power, but does not affect fatigability or specific tension[J]. J Clin Endocrinol Metabo, 2003; 88(4): 1478-1485.
- 9. Pope HG Jr, Cohane GH, Kanayama G, Siegel AJ, Hudson JI. Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial[J]. Am J Psychiatry, 2003; 160(1): 105-111.
- 10. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging[J]. Urology, 2004; 63(4): 641-646.
- 11. Leibenluft E, Schmidt PJ, Turner EH, Danaceau MA, Ashman SB, Wehr TA, Rubinow DR. Effects of leuprolide-induced hypogonadism and testosterone replacement on sleep, melatonin, and prolactin secretion in men[J]. J Clin Endocrinol Metab, 1997; 82(10): 3203-3207.
- 12. Ly LP, Jimenez M, Zhuang TN, Celermajer DS, Conway AJ, Handelsman DJ. A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency[J]. J Clin Endocrinol Metab, 2001; 86(9): 4078-4088.
- 13. Bergamini E. Tstosterone and sugar transport in levator ani muscle of rat[J]. Biochim Biophys Acta, 1969; 193(1): 193-202.
- 14. Park NC, Yan BQ, Chung JM, Lee KM. Oral testosterone undecanoate (Andriol) supplement therapy improves the quality of life for men with testosterone deficiency[J]. Aging Male, 2003; 6(2): 86-93.
- 15. Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ. The short-term effects of high-dose testosterone on sleep, breathing, and function in older men[J]. J Clin Endocrinol Metab, 2003; 88(8): 3605-3613.
- 16. Huang ZM, Han YF, Li Z. The study of whether testosterone supplement therapy improving the risk of benign prostatic hyperplasia[J]. Chinese Male Science Journal, 2002; 16(5): 364-366, 369.
- 17. Behre HM, Bohmeyer J, Nieschlag E. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls[J]. Clin Endocrinol (Oxf), 1994; 40(3): 341-349.
- 18. Gooren LJ. A ten-year safety study of the oral androgen testosterone undecanoate[J]. J Androl, 1994; 15(3): 212-215.