CAJ | 학술논문

目的比较低剂量甲睾酮及安雄(十一酸睾酮)对老年男性骨质疏松患者骨密度、生命质量的影响及安全性. 方法选择血清游离睾酮水平低于正常值的老年男性骨质疏松患者134例,按用药方案分为甲睾酮组45例,甲睾酮1 mg,1次/d舌下含服;安雄组46例,安雄40 mg,1次/d口服;对照组43例,安慰剂,1次/d舌下含服.治疗时间为1年.测定治疗前后骨密度、骨代谢相关血和尿生化指标、生命质量指标和前列腺B超、血清前列腺特异抗原、血尿常规、肝肾功能等. 结果低剂量甲睾酮和安雄均可防止老年男性骨质疏松患者各部位骨密度进一步下降(均为P＜0.05),股骨颈骨密度在甲睾酮组和安雄组治疗前后差值分别为(0.14±0.18)g/cm2和(0.12±0.09)g/cm2(P＜0.05);安雄治疗在升高血游离睾酮[(32.5±14.2)ng/L]水平作用强于甲睾酮((19.3±9.2)ng/L](P＜0.05);两种激素均能改善患者总体健康、情绪角色功能和精力,低剂量安雄治疗在改善躯体健康和躯体角色功能方面优于低剂量甲睾酮. 结论低剂量甲睾酮和安雄均可用于老年男性骨质疏松的治疗,同时可提高其生命质量,是一种安全、有效的治疗选择.
목적 비교저제량갑고동급안웅(십일산고동)대노년남성골질소송환자골밀도、생명질량적영향급안전성. 방법 선택혈청유리고동수평저우정상치적노년남성골질소송환자134례,안용약방안분위갑고동조45례,갑고동1 mg,1차/d설하함복;안웅조46례,안웅40 mg,1차/d구복;대조조43례,안위제,1차/d설하함복.치료시간위1년.측정치료전후골밀도、골대사상관혈화뇨생화지표、생명질량지표화전렬선B초、혈청전렬선특이항원、혈뇨상규、간신공능등. 결과 저제량갑고동화안웅균가방지노년남성골질소송환자각부위골밀도진일보하강(균위P＜0.05),고골경골밀도재갑고동조화안웅조치료전후차치분별위(0.14±0.18)g/cm2화(0.12±0.09)g/cm2(P＜0.05);안웅치료재승고혈유리고동[(32.5±14.2)ng/L]수평작용강우갑고동((19.3±9.2)ng/L](P＜0.05);량충격소균능개선환자총체건강、정서각색공능화정력,저제량안웅치료재개선구체건강화구체각색공능방면우우저제량갑고동. 결론 저제량갑고동화안웅균가용우노년남성골질소송적치료,동시가제고기생명질량,시일충안전、유효적치료선택.
Objective To evaluate the therapeutic efficacy of low-dosage methyltestosterone or andriol in men with senile osteoporosis. Methods A total of 134 male patients with senile osteoporosis and the decreased serum level of free testosterone were divided into three groups. 45 patients were treated with low-dosage methyhestosterone(100 mg, once a day, sublingual) and 46 patients were treated with low-dosage andriol (40 mg, once a day, orally), while 43 patients were treated with placebo. The duration of treatment in each group was 1 year. The bone density, blood and urine biochemical indexes related to bone metaholites,the quality of life indexes, ultrasonography for prostate,serum prostate specific antigen,blood routine, urine routine, hepatic and renal function were detected before and after the treatment. Results Both low-dosage methyltestosterone and low-dosage andriol could prevent the decrease of bone mineral density and improve patients' general health, role-emotional function and vitality (all P＜0.05). The difference values of femoral neck bone mineral density before and after treatment with low-dosage andriol and low-dosage methyltestosterone were (0.14+0.18)g/cm2 and (0.12±0.09)g/cm2 , respectively(P＜0.05). Low-dosage andriol hadstronger effects in increasing the level of estradiol (32.5±14.2 )ng/L than low-dosage methyltestosterone(19.3±9.2)ng/L(P＜0.05) and showed more notable effects in improving the physical functioning and role-physical function than low-dosage methyhestosterone. The use of the two androgenic hormones at low dosage showed safety. Conclusions Both low-dosage methyltestosterone and low-dosage andriol can be used to treat senile osteoporosis in men and to improve life quality. Both of them are effective and safe therapeutic choices.