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題名 | Serum Testosterone Levels in Patients with Chronic Obstructive Pulmonary Disease=血中睪固酮濃度在慢性阻塞性肺疾病病人的分析 |
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作者姓名(中文) | 胥愛璽; 陳鼎源; 李仁智; | 書刊名 | 慈濟醫學 |
卷期 | 18:2 民95.04 |
頁次 | 頁113-120+162 |
分類號 | 415.428 |
關鍵詞 | 慢性阻塞性肺疾病; 睪固酮; 身體質量比; Chronic obstructive pulmonary disease; Testosterone; Body mass index; |
語文 | 英文(English) |
中文摘要 | 目的:分析血中睪固酮濃度在慢性阻塞性肺疾病病人的分布情況及其影響。材料與方法:於2005年7月至9月40位於慈濟醫院花蓮院區因慢性阻塞性肺疾病治療的病人,依其所屬相關疾病之不同,參照GOLD對慢性阻塞性肺疾病嚴重度分期標準,區分病人為四組:第一組共10人次,相對於GOLD為0期;第二組共14人次,相對為GOLD2期;第三組共8人次,相對為GOLD3期;第四組共8人次,相對為GOLD4期,其臨床症狀最為嚴重。同時在慈濟醫院花蓮院區因泌尿科門診收集173位50歲以上健康男性作為對照組。本研究收集分析病人的年齡、疾病嚴重度、身體質量比、間峰吐氣流速及血中睪固酮濃度之關係,以期分析出何種因素與不良預後相關,並探討可否藉改變此因素以改善其預後。結果:在本研究中,以臺灣健康男性及慢性阻塞性肺疾病男性為對象,其血中睪固酮濃度低下(小於3ng/mL)的盛行率分別是百分之25及百分之23。而以臺灣健康男性為對象分析,發其血中睪固酮濃度範圍介於4.136至4.687 ng/mL。值得注意的是,在第四組極重度慢性阻塞性肺疾病組的病人有較低的血中睪固酮濃度以及較低的平均身體質量比。而在第一、二、三組及對照組病人,則在各項目皆無明顯差異。結論:血中睪固酮,可能在影響極重度慢性阻塞性肺疾病的病人的身體骨骼肌消耗中扮演角色,因此國外有些實驗提出給予口服或針劑之睪固酮可改善極重度慢性阻塞肺疾病組的病人臨床上身體骨骼肌減少的情況,以期改變其預後,但值得注意的事增加極重度慢性阻塞性肺疾病病人的身體骨骼肌的質量雖然可增加病人的骨骼肌肌力,但若要改善病人的運動活動力,則除了骨骼肌與呼吸肌肌力改善之外還牽涉整體之心肺功能的改善。 |
英文摘要 | Objective: To characterize the serum testosterone distribution in a population with chronic obstructive pulmonary disease (COPD) and discuss the potential impacts of anabolic steroids in weight-depleted COPD patients. Materials and Methods: Between July and September 2005, forty male participants aged over 50 years who COPD were enrolled and divided into 4 groups of increasing severity (I~IV). The grouping method was based on the classification of COPD severity suggested by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The control group included 173 age-matched healthy males who were being followed-up in the urology clinics of Tzu Chi General Hospital and was labeled group V. One-way ANOVA and t-test were used to test for differences in several variables including age, serum testosterone level, peak flow meter values (PEF), and body mass index (BMI) among these 5 groups. Results: In this study, the prevalences of hypogonadism (defined as total serum testosterone of < 3 ng/mL) in healthy aging males and COPD patients were 25% and 33%, respectively. The testosterone level in group IV (with the most severe COPD) was lower than those of the other groups. After removing group IV, the 95% confidence interval of serum testosterone level was between 4.136 and 4.687 ng/mL. In addition, group IV was independently isolated, and the t-test was used to compare differences between group IV and the other 4 groups as a whole. The results confirmed that the serum testosterone level, PEF, and body mass index in group IV were significantly lower than those of the other 4 groups. Conclusions: Testosterone levels showed no significant differences among group I, II, III, and V in this study; however, patients in group IV might have decreased maintenance of serum testosterone levels, and this might be considered to contribute to the skeletal muscle wasting in some COPD patients. |
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