老年男性心力衰竭患者性激素水平调查及与同龄健康男性的比较

目的了解老年男性心力衰竭(心衰)患者性激素水平及与心功能之间的关系。方法临床诊断为慢性心衰的男性住院患者共100例,年龄在60~87(70.35±8.63)岁,超声心动图检查左室射血分数≤0·45,同时观察健康老年男性400例(71.25±6.81)岁]作为正常对照。采集其晨起静脉血,低温离心后取血清,测定总睾酮、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇、黄体生成素(LH)、卵泡刺激素(FSH)水平,并在同龄心衰患者及健康男性之间进行比较。结果(1)心衰患者DHEAS水平随着年龄的增加降低(P<0.05),而SHBG、LH、FSH水平则随着年龄的增加而增加(P<0.05,P<0.01)。(2)与同龄健康男性相比,心衰患者总睾酮、FT、雌二醇、DHEAS明显降低(P<0.01),LH、FSH差异无统计学意义。SHBG水平显著增加(P<0.01)。(3)FT水平与左室射血分数呈显著正相关(r=0.279,P=0.034)。结论老年男性心衰患者的雄激素水平显著降低,且FT水平与心衰程度呈负相关。

A comparative survey of sex hormones levels between elderly men with chronic heart failure and normal elderly subjects

OBJECTIVE: To understand the sex hormone levels in elderly men with chronic heart failure and the relationship between sex hormone levels and heart function. METHODS: One hundred male patients diagnosed chronic heart failure clinically aged from 60 to 87 were selected in this study. All patients' left ventricular ejection fraction were less than 0.45. Four hundred elderly healthy men were studied as control. Blood samples were collected in the morning and TT, FT, DHEAS, SHBG, E(2), LH, FSH were measured. The results were compared with the hormone levels of healthy men with the same mean age. RESULTS: (1) In elderly men with chronic heart failure, the level of DHEAS was decreased with age (P < 0.05). However, the levels of SHBG, LH, FSH were increased with age (P < 0.05, P < 0.01). (2) Compared with healthy men the levels of TT, FT, E(2) and DHEAS were decreased significantly (P < 0.01) and the level of SHBG was significantly increased (P < 0.01). (3) The level of FT was positively correlated with LVEF (r = 0.279, P = 0.034). CONCLUSION: The androgen levels in elderly male patients with chronic heart failure were decreased significantly and the level of FT was negatively correlated with degree of heart failure.