本文選題：特發(fā)性低促性腺激素性性腺功能減退癥(IHH) + 脈沖泵��； 參考：《中華生殖與避孕雜志》2017年04期

【摘要】：目的探討促性腺激素釋放激素(GnRH)泵治療成年男性特發(fā)性低促性腺激素性性腺功能減退癥(IHH)患者的療效與安全性。方法對(duì)確診為IHH的27例成年男性患者進(jìn)行GnRH泵脈沖式皮下輸注治療,比較觀察患者治療前后性激素、第二性征、外生殖器、性功能、生育能力的變化情況和不良反應(yīng)情況。結(jié)果平均隨訪時(shí)間13.3(2~38)個(gè)月,治療1年以上18例,6個(gè)月~1年2例,3~6個(gè)月3例,3個(gè)月以下4例�；颊咧委熐捌骄G丸體積(3.38±2.03)mL,陰莖靜息長(zhǎng)度(3.63±1.10)cm,陰莖牽長(zhǎng)(5.73±1.53)cm,陰莖周徑(5.13±1.38)cm,黃體生成素(LH)(0.67±0.63)IU/L,卵泡刺激素(FSH)(1.27±0.88)IU/L,睪酮(T)(0.50±0.53)ng/mL;用泵治療6個(gè)月患者睪丸體積(6.48±2.14)mL,陰莖靜息長(zhǎng)度(4.85±0.83)cm,陰莖牽長(zhǎng)(7.90±1.27)cm,陰莖周徑(7.27±1.33)cm,LH(6.72±5.35)IU/L,FSH(5.48±3.23)IU/L,T(2.36±1.37)ng/mL,均較治療前顯著提高(P0.01)。用泵治療1年以上患者睪丸體積(8.78±2.24)mL,陰莖靜息長(zhǎng)度(5.78±0.75)cm,陰莖牽長(zhǎng)(9.31±1.31)cm,陰莖周徑(7.94±0.84)cm,LH(6.56±3.89)IU/L,FSH(5.04±2.49)IU/L,T(3.57±1.08)ng/mL,均較治療前顯著提高(P0.01),外生殖器、T較6個(gè)月前有顯著提高(P0.05)。治療前25例患者無(wú)手淫,無(wú)遺精,僅有2例患者有遺精(精液中無(wú)精子),治療6個(gè)月以上20例患者均相繼出現(xiàn)遺精并伴經(jīng)常性勃起,其中18例患者取得精液,13例出現(xiàn)精子,2例已婚患者配偶自然妊娠。所有患者治療期間未見明顯不良反應(yīng),患者依從性良好。結(jié)論 GnRH泵治療成年男性IHH療效顯著且安全性好,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the efficacy and safety of gonadotropin releasing hormone (GnRH) pump in the treatment of adult male idiopathic hypogonadic hypogonadism (IHH). Methods 27 adult male patients with IHH were treated with GnRH pump pulse subcutaneous infusion, and the sex hormone, secondary sex syndrome, and exotropion were observed before and after treatment. The average follow-up time was 13.3 (2~38) months, 18 cases for more than 1 years, 2 cases in 6 months ~1, 3 for 3~6 months and 4 in 3 months. The average volume of testis (3.38 + 2.03) mL before treatment, penile resting length (3.63 1.10) cm, penile stretch (5.73 + 18) cm, penis circumference ( 5.13 + 1.38) cm, luteinizing hormone (LH) (0.67 + 0.63) IU/L, follicle stimulating hormone (1.27 + 0.88) IU/L, testosterone (T) (0.50 + 0.53) ng/mL, and pump for 6 months for patients with testicular volume (6.48 + 2.14) mL, penile resting length (4.85 + 0.83) cm, penile length (0.67) cm, penile circumference cm, LH Ng/mL (+ 1.37) was significantly higher than that before the treatment (P0.01). The volume of testicular (8.78 + 2.24) mL, penile resting length (5.78 + 0.75) cm, penile stretch (9.31 + 1.31) cm, penis circumference (7.94 + 0.84) cm, LH (6.56 + 3.89) IU/L, FSH (5.04 + 3.89) IU/L and T ng/mL, were significantly higher than before treatment. Compared with 6 months ago (P0.05), 25 patients had no masturbation, no spermatogenesis, no spermatogenesis, only 2 patients had spermatozoa (spermatozoa in semen), and 20 patients received spermatozoa and recurrent erectile in 20 cases over 6 months, of which 18 patients obtained semen, 13 had spermatozoa, and 2 married couples had natural pregnancy. All patients were treated in the treatment period. No obvious adverse reactions were observed. The compliance of patients was good. Conclusion GnRH pump is effective and safe in the treatment of adult male IHH. It is worthy of clinical application.
【作者單位】： 第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所泌尿外科;
【分類號(hào)】：R698

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