血清睾酮及雌二醇与老年男性痴呆类型和严重程度的关系

目的探讨血清总睾酮(TT)、雌二醇(E2)与老年男性痴呆类型和严重程度的关系。方法选择111例男性老年人,将认知功能正常的老年人28例作为正常组,轻度认知损害(MCI)患者15例作为MCI组,阿尔茨海默病(AD)患者50例作为AD组(其中轻、中、重度分别为17、18和15例),血管性痴呆(VaD)患者18例作为VaD组,检测TT和E2浓度。痴呆严重程度根据通用的临床痴呆评价量表评分。应用协方差分析、相关分析和χ~2检验方法分析TT、E2与AD和VaD及其严重程度的关系。结果 MCI组、正常组和轻度AD患者的TT和F2水平差异均无统计学意义。AD组患者TT和E2水平明显低于正常组(P<0.05)。随着认知损伤程度的加重,AD组患者TT呈下降趋势(Spearman's ρ_s=-0.4709,P<0.001),且TT低下患者的比例增多。VaD组、AD组、正常组3组间比较,TT和E2水平以及TT和E2低下患者的比例差异均无统计学意义。结论 TT下降与AD及其严重程度相关,血清E2下降与AD相关,但与其严重程度无关,二者与VaD均无明显相关性。

The relation of endogenous testosterone and estradiol to the dementia type and its severity in old men

Objectives To investigate the relation of levels of endogenous total testosterone(TT) and estradiol(E2) to the dementia type and its severity in old men. Methods Fifteen male patients with mild cognitive impairment(MCI), 50 male patients with Alzheimer's disease(AD), 18 male patients with vascular dernentia(VaD), and 28 normal controls were enrolled. All participants received serum TT and E2 concentration measurement and standard neuropsychological examination. The severity of AD was evaluated using Clinical Dementia Rating Scale. The statistic methods included covariance analysis, Spearman correlation analysis, and chi square test. Results No significant changes of TT and E2 levels were found in men with MCI. Levels of TT and E2 were significantly lower in men with AD compared with controls (P<0.05). Levels of TT in men with AD decreased with the severity of dementia (Spearman's ρ_s=-0.4709, P<0.001). There was no significant decline in serum TT and E2 in patients with VaD compared with AD or with controls. Conclusions The decrease in endogenous TT in men with dementia was associated with AD and its severity,and E2 was associated with AD rather than its severity. No changes of TT and E2 was found in men with VaD.