~(131)Ⅰ治疗Graves甲亢对男性患者性激素及性功能的影响

目的:观察放射性131Ⅰ治疗男性Graves甲亢患者早期血清性激素和性功能的变化。方法:男性Graves甲亢患者34例,年龄21～40(32.3±6.7)岁,给予131Ⅰ治疗剂量为111～407(237.8±51.8)MBq,在131Ⅰ治疗前及治疗后3、6个月分别检测血清甲状腺激素及性激素,同时对患者进行勃起功能问卷评分(IIEF-5)调查。用同期体检的健康男性20例作为对照,年龄25～37(31±3.1)岁。结果:男性Graves甲亢患者雌激素、睾酮、促黄体生成素水平分别为(132.5±40.4)pmol/L、(21.6±4.6)nmol/L、(10.1±4.4)IU/L,明显高于健康对照组的(80.4±31.2)pmol/L、(14.5±4.2)nmol/L、(6.2±1.9)IU/L(P<0.05)。131Ⅰ治疗3个月后血清雌激素、睾酮水平为(110.2±20.6)pmol/L、(17.7±5.5)nmol/L,较治疗前明显下降(P<0.05)。治疗6个月后雌激素、睾酮、促黄体生成素水平为(82.6±30.1)pmol/L、(13.8±3.4)nmol/L、(6.6±1.5)IU/L,与健康对照组相比无差别(P>0.05)。男性Graves甲亢患者IIEF-5评分为5～25(15.5±3.5)分,明显低于对照组的19～25(24.5±0.5)分(P<0.05)。131Ⅰ治疗后6个月组为10～25(23.5±1.5)分,明显高于3个月组的8～25(19.5±1.0)分(P<0.05)。结论:男性Graves甲亢患者雌激素、睾酮、促黄体生成素水平明显增高,性功能评分(IIEF-5)明显降低。使用131Ⅰ治疗6个月后,患者血清睾酮、促黄体生成素,雌激素水平以及IIEF-5评分基本恢复正常。Graves甲亢患者使用131Ⅰ治疗可明显改善其性功能。

Radioiodine-131 therapy improves sex hormones and sexual function in male patients with Graves' disease

Objective: To observe the changes of sex hormones and sexual function in male patients with Graves’ disease(GD) after Radioiodine-131(I-131) therapy.Methods: Thirty-four male GD patients,aged 21-40(32.3±6.7) years,were treated with I-131 at the dose of 111-407(237.8±51.8) MBq.The levels of serum sex hormones were measured,and the patients’ scores on erectile function(IIEF-5) were obtained before and 3 and 6 months after the treatment.Another 20 healthy men aged 25-37(31±3.1) years were enlisted as controls.Results: The baseline levels of estrogen(E2),testosterone(T) and luteinizing hormone(LH) were(132.5±40.4) pmol/L,(21.6±4.6) nmol/L and(10.1±4.4) IU/L in the GD patients,significantly higher than(80.4±31.2) pmol/L,(14.5±4.2) nmol/L and(6.2±1.9) IU/L in the healthy controls(P<0.05).The E2,T and LH levels showed a significant decrease in the GD patients after 3 months of treatment([110.2±20.6] pmol/L,[17.7±5.5] nmol/L and(9.4±3.9) IU/L,P<0.05),but exhibited no statistically significant differences from the healthy controls at 6 months([82.6±30.1] pmol/L,[13.8±3.4] nmol/L and [6.6±1.5] IU/L,P>0.05).The IIEF-5 score of the GD patients was 5-25(15.5±3.5) before I-131 treatment,significantly lower than that of the controls(19-25,24±0.5)(P <0.05),and it was 8-25(19.5±1.0) at 3 months and 10-25(23.5 ±1.5) at 6 months,significantly higher in the latter than in the former(P<0.05),and with no significant difference between the 6-month treated patients and the healthy controls(P>0.05).Conclusion: The E2,T and LH levels are increased while the IIEF-5 score decreased markedly in male GD patients.Six-month treatment with I-131 can not only restore the E2,T and LH levels to normal but also significantly improve the patient’s sexual function.