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目的:探索中老年男性勃起功能障碍(erectile dysfunction,ED)与多种性激素之间的关系。方法:对上海市某社区928名40~70岁中老年男性进行问卷调查,采用“勃起功能国际问卷-5(IIEF-5)”量表进行评估,并抽取空腹静脉血,采用免疫学方法测定血清总睾酮(TT)、游离睾酮(FT)、催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)及性激素结合球蛋白(SHBG)水平。按照各激素的四分位数点将对象分为4组(P0~P24组、P25~P49组、P50~P74组和P75~P100组),比较不同水平激素ED的患病风险。结果:40~50岁、51~60岁、61~70岁组的ED患病率分别为52.34%、73.14%、90.18%。调整潜在混杂因素后,FT水平的P0~P24组、P25~P49组、P50~P74组ED的患病危险性,比P75~P100组高,aOR分别为1.54、1.42、1.52,但其95%可信区间(95%CI)下限略小于1。PRL和FSH水平低的对象,患病风险较低;PRL水平在P0~P24组、P25~P49组、P50~P74组的aOR分别为0.61、0.79、0.58,除P25~P49组外,关联均有统计学意义;FSH水平在P0~P24组、P25~P49组、P50~P74组的aOR分别为0.55、0.48、0.60,除P50~P74组95%CI上限稍大于1外,关联均有统计学意义。而ED与TT、SHBG、LH、E2等的关联没有统计学意义。以上各激素与重度ED的关联均无统计学意义。结论:调整年龄及其他混杂因素后,ED与血清PRL、FSH水平存在统计学关联,与FT水平的关联较弱,与TT、LH、SHBG、E2水平的关联没有统计学意义。就现有研究结果,尚不能认为激素水平的变化对中老年人ED的发生起主要作用。
Objective: To explore the relationship between erectile dysfunction (ED) and various sex hormones in middle-aged and elderly men. Methods: A total of 928 middle-aged and elderly men aged from 40 to 70 in a community in Shanghai were surveyed and assessed using the International Erectile-Function Questionnaire-5 (IIEF-5) scale. Fasting venous blood Methods The levels of total testosterone (TT), free testosterone (FT), prolactin (PRL), LH, FSH, SHGG . The subjects were divided into 4 groups (P0 ~ P24 group, P25 ~ P49 group, P50 ~ P74 group and P75 ~ P100 group) according to the quartiles of each hormone, and compared the risk of different levels of hormone ED. Results: The prevalences of ED in 40-50 years old, 51-60 years old and 61-70 years old group were 52.34%, 73.14% and 90.18% respectively. After adjusting for potential confounders, the prevalence of ED in FT-level groups P0 ~ P24, P25 ~ P49, and P50 ~ P74 was higher than that in P75 ~ P100 group with aOR of 1.54, 1.42 and 1.52, respectively, but 95% The lower limit of the confidence interval (95% CI) is slightly less than one. Patients with low PRL and FSH levels had a lower risk of disease. The PRL levels were 0.61, 0.79 and 0.58 in P0 to P24, P25 to P49, and P50 to P74, respectively, with the exception of P25 to P49 There was statistical significance; FSH level in P0 ~ P24 group, P25 ~ P49 group, P50 ~ P74 group aOR were 0.55,0.48,0.60, except P50 ~ P74 group 95% CI upper limit slightly larger than 1, the statistics are related Significance of learning. The correlation between ED and TT, SHBG, LH, E2 and so on was not statistically significant. The correlation between the above hormones and severe ED was not statistically significant. CONCLUSIONS: After adjusting for age and other confounding factors, there is a statistical relationship between ED and serum PRL and FSH levels, and the correlation between ED and FT is weak. There is no significant correlation between ED, TT, LH, SHBG and E2 levels. The existing findings, we can not yet believe that changes in hormone levels in the elderly ED play a major role.