ªø©°°ü²£³q°T--²Ä32´Á
 
¶¯©Ê¯À¸É¥RÀøªk¡]Androgens Replacement Therapy, ART¡^¦b§ó¦~´Á°ü¤kªº¨¤¦â

¥x¥_°|°Ï ¥DªvÂå®v ³¯¥ú¬L

¡@¡@ ¤k©Êªº§Z±_¦b§ó¦~´Á«á¦]¬°¤Àªc»Û¿E¯Àªº¶q·¥³t¤U­°¡A¦]¦¹®e©öµo¥Í¦åºÞ¹B°Ê¾÷¯à¤£Ã­©wªº¯gª¬¡A½Ñ¦p¼ö¼é¬õ¡B¤ß±ª¡B©]¦½µ¥¡C¥Ø«e¹ï©ó»Û¿E¯Àªº¬ã¨s¡A¤wµý¹êªA¥Î»Û¿E¯À¥i¥H§ïµ½§ó¦~´Á¯g­Ô¸s¡C¤×¨ä³ÌªñÂå¾Ç¬É¹ï©ó»Û¿E¯À»P°©½è²¨ÃP¡B¤ß¦åºÞ¯e¯f¡B¨ÅÀù©Î¦Ñ¤Hè§b¯gªº¬ã¨s¡A¤]¨Ï¤H­Ì¹ïªø´ÁªA¥Î»Û¿E¯Àªº§Q»P¹ú¡A¦³¤F§ó³zº«ªº¤F¸Ñ¡Cªñ´X¦~¨Ó§Ü¦ÑÂå¾Ç³vº¥¿³²±¡AÂå¾Ç¬É¤Î°Ó·~¬É§âµJÂI§ëª`¦b¥t¤@ºØ¤HÃþªº²üº¸»X---¶¯©Ê¯À¡C°ò©ó°Ó·~ªº§Q¯q¡A³\¦h§t¦³¸A©Tଡ]testosterone¡^©Î¨ä­l¥Íª«ªºÃÄ«~³Q¥Î¨Ó§MÀø¨k©Ê©Î¤k©Ê§ó¦~´Á§C©Ê¼¤ªº¯gª¬¡F¥t¥~¬Y¨Ç°·±d­¹«~¤]ÃB¥~²K¥[DHEAªº¦¨¥÷¡A¥´µÛ§Ü°I¦ÑªºÂåÀø®ÄªG¡B¼W¶i¨â©Êªº¡u©Ê¡vºÖ¡A¦b¥«´­¤W¤j¦æ¨ä¹D¡C¨ä¹ê¯¸¦bÂå¾ÇÆ[ÂI¡A®ÚÕuªñ´X¦~ªºÂå¾Ç¤åÄm¨ÓµÛ¡A¤HÃþ¹ï©ó¶¯©Ê¯À¥Í²z¾ÇªºÁA¸Ñ©|¥¼¹³»Û¿E¯À¯ë¦a³zº«¡C°I¦Ñªº¹Lµ{©Î³\¥i¥H¸ÑÄÀ§Z±_¤ÎµÇ¤W¸¢¤Àªc¶q´î¤Öªº³¡¤À­ì¦]¡A¦ý¬O¶¯©Ê¯À¦b¦ÛµMªº°±¸g¹Lµ{¤¤¡A¨ä¤Àªc¶q¨Ã¤£¹³»Û¿E¯À¯ë·¥³t¤U­°¡A¦Ó¬O½wºC¤U­°ªº¡C¦Ó¶¯©Ê¯À¤U­°ªº¹Lµ{¤¤©Ò¦ñÀHªº¯gª¬¡A¤]¤£¹³»Û¿E¯À¯Ê¤§©Ò¤Þµoªº¦åºÞ¹B°Ê¾÷¯à¤£Ã­©w¯gª¬¨º»ò¦a©úÅã¡CÁöµM¨Ì¥Ø«eªºÂå¾Ç¬ã¨sÅã¥Ü¡A¨Ï¥Î¶¯©Ê¯À¹ï©ó¬Y¨Ç¾¹©x¦p°©ÀY¡B¤j¸£¦³¥¿­±¯S©wªº®Ä¯q¡A¦ý¬O¬O§_ªA¥Î¶¯©Ê¯À´N¥i¥H§ïÅܶ¯©Ê¯À¤U­°©Ò¤Þµoªº¯gª¬¡A¤´¦³·¥¤jªº°ÓºeªÅ¶¡¡C¦Ó¥B©ÒªA¥Îªº¶¯©Ê¯À¬O¥~¨Óªº¡A¤£¬O¨­Åé©Ò¦Û¤v»s³yªº¡C¦]¦¹©Ò¤Þ°_ªº¥Í²z¤ÏÀ³¬O§_»P¤º·½©Êªº¶¯©Ê¯À©Ò²£¥Íªº®ÄªG¬Û¦ü¡A¥Ø«eªº¬ã¨s¸ê®Æ¤´µMµLªkµý¹ê¡C¦]¦¹¥H¤U±N´N¶¯©Ê¯Àªº¥Í²z¾Ç¤Î¥Í²z®ÄÀ³¡A¶¯©Ê¯À¯Ê¥F®É©Ò¦ñÀHªº¯gª¬¡A¤Î¥~·½©Ê¶¯©Ê¯Àªº¨Ï¥Î»Pª`·N¨Æ¹z¡A§@¤Jªù©Êªº¤¶²Ð¡AÅýŪªÌ¹ï©ó§ó¦~´Á°ü¤k¬O§_»Ý­n¨Ï¥Î¶¯©Ê¯À¦³°ò¥»ªº»{ÃÑ¡C

¤k©Ê¶¯©Ê¯Àªº¥Í²z¾Ç

¤k©Ê¶¯©Ê¯Àªº²£¥Í³Ì¥D­n¦³¤TºØ¨Ó·½¡A§Y§Z±_¡BµÇ¤W¸¢¤Î©PÃä²Õ´¡C©PÃä²Õ´¨ã¦³¶¯©Ê¯À¶¡¬Û¤¬«×Âà´«¤Î±N¶¯©Ê¯ÀÂàÅܦ¨»Û¿E¯Àªº¥ô°È¡C¨Ò¦p¦b¤òÅn¥Ö¯×¸¢¤¤¡A¥¦¥i¥HÂǵ۱Ntestosterone¤ÎandrostenedioneÂà´«¦¨§ó¨ã¶¯©Ê¯À®Ä¤Oªºdihydrotestosterone¤Îandrostenedione¡C¦å²M¤¤testosteroneªº¿@«×¥i¥H·í§@´ú¶q§Z±_¶¯©Ê¯À²£¶qªº¤@ºØ«ü¼Ð¡CTestosterone¦b¤ë¸g¶g´Á¤¤´Á¡AÃþ¦üLH¤@¼Ë¦³¤@­Ó¤pªº¦y®p´Á¡A¨ä¾l®É¶¡«h«O«ù«í©wªº¿@«×¡C°±¸g«á¶¯©Ê¯À¦b§Z±_¤ÎµÇ¤W¸¢¤Àªc¶q´î¤Ö¸û¦h¡A¦b©PÃä²Õ´´î¤Öªº¶q«h¬Û¹ï¦a¸û¤Ö¡C°±¸g«áandrostenedioneªº´î¤Ö¶q¤ñtestosterone¨Óªº¦h¡C

¤j³¡¤Àªº¬ã¨sÅã¥Ütestosterone¦b°±¸g«áªº¤U­°³t²v¬O«D±`½wºCªº¡A¦Ó¥B¨ä¤U­°³t²v»PLHªº¿@«×¦³Ãö¡C¦]¦¹¦b°±¸g«áªº°ü¤k¡A§Z±_ÁÙ¬O«O¦³¤Àªctestosterone¤Îandrostenedioneªº¯à¤O¡C©Ò¥H°±¸g´Á±µ¨üÂù°¼§Z±_¤Á°£ªº°ü¤k¡A¨ä¤Àªctestosterone¤Îandrostenedioneªº¯à¤O¤j¬ù³à¥¢50%¥ª¥k¡C³q±`¦b«D±`¦Ñªº°ü¤k¡]¥­§¡71-90·³¥ª¥k¡^¡Atestosterone¤~·|ÅãµÛªº­°§C¡C

¥t¥~¦³¤@­Ó¤ñ­È¬O­È±o§Ú­Ì¥hª`·Nªº¡A§YDHEA-S/Testosteroneªº¤ñ­È¡CÁöµM±q¤G¤Q¨ì¤­¤Q·³®É¡A¦å²G¤¤ªºtestosterone¦³½wºC¤U­°¡A¦ýDHEA-S/Testosterone«o¦b°±¸g«e»P°±¸g«á«O«ùùÚ©w¡C

¶¯©Ê¯À¦b¤k©Êªº¥Í²z®ÄÀ³

¶¯©Ê¯À¹ï©Ê¼¤ªº¼vÅT

¬ã¨sÅã¥Ü©Ê¼¤ªº°ª§C¡]§Y©Ê¥æªº¦¸¼Æ¡^»P¦å¤¤testosteroneªº¿@«×¦³¥¿¬ÛÃö©Ê¡C¹ï±µ¨ü¤l®c¤ÎÂù°¼§Z±_¤Á°£ªº°ü¤kµ¹¤©¶¯©Ê¯À¡A¥i¥H¼W¥[©Ê¼¤¡F¦ý¹ï¯­±µ¨ü¤l®c¤Á°£ªº°ü¤kµ¹¤©¶¯©Ê¯À¡A«h¹ï©ó¼W¥[©Ê¼¤¨S¦³¦h¤j§U¯q¡C¨ä¥L¤åÄm¤]Åã¥Ü¶¯©Ê¯À¹ï±µ¨üÂù°¼§Z±_¤Á°£ªº°ü¤k¡A¦b¼W¥[©Ê¼¤¤è­±¦ü¥G¦³¶W¥G·Q¹³¯ëªº®ÄªG¡C

¶¯©Ê¯À¹ï¦åºÞ¹B°Ê¾÷¯àªº¼vÅT

¦­¦b1950¦~´N¤v¸gª¾¹D¶¯©Ê¯À¤]¯à§ïµ½°±¸g°ü¤kªº¦åºÞ¹B°Ê¾÷¯à¤£Ã­©wªº¯gª¬¡A½Ñ¦p¼ö¼é¬õ¡B¤ß±ª¡B©]¦½µ¥¡C³\¦hªºÁ{§É¸ÕÅçµo²{¥H0.625mg©Î1.25mgªº»Û¿E¯À¥[¤W2.5mgªº¥Ò°ò¤Æ¶¯©Ê¯À¡]methyltestosterone¡^ªvÀø¦åºÞ¹B°Ê¾÷¯à¤£Ã­©w¯gª¬ªº®ÄªG¡A¤ñ³æ¿W¨Ï¥Î»Û¿E¯À¨Ó±o¦n¡C¦ý¬O­Y¨Ï¥Î°ª¾¯¶q¡]5mg¡^ªº¥Ò°ò¤Æ¶¯©Ê¯À¥[¤W»Û¿E¯À¡]0.625mg¡^ªvÀø¡A«h®ÄªG¤£¦p³æ¥Î»Û¿E¯À¦³®Ä¡C

¶¯©Ê¯À¹ï±¡ºüªº¼vÅT

ªñ¦~¨Ó¶¯©Ê¯À¬O§_¥i¥Î©ó§MÀø§ó¦~´Á°ü¤kºë¯«¤è­±ªº°ÝÃD¡A¤v¨ü¨ì¼sªxªºª`·N¡C³\¦hªº¤åÄm¤v³ø§i¡A³æ¿W¨Ï¥Î¶¯©Ê¯À©Î¶¯©Ê¯À»P»Û¿E¯À¦X¨Ö¨Ï¥Î¡A§¡¯à¨Ï¯f¤HÅܱo§ó¼ÖÆ[¶i¨ú¡B¦³¬¡¤O¡A´£°ª­¹¼¤¡A¬Æ¦Ü¥i¥H§ïµ½¥¢¯v¤Î³±¹D°®Àꪺ¯gª¬¡C¤×¨ä¬O¨Ï¥ÎDHEAªÌ¡A®ÄªG¥i¥H¦b¤G¶g¤§¶¡¹F¨ì¦³®Ä§MÀøªº¶¯©Ê¯À¿@«×¡C¦ý¬ODHEA»P»Û¿E¯À·f°t¨Ï¥Îªº®ÄªG¡A©|«Ýªñ¤@¨BªºÁ{§É¬ã¨s¡C

¶¯©Ê¯À¹ï°©½èªº¼vÅT

¦b³y°©²Ó­M¡]osteoblast¡^¤¤¦³¶¯©Ê¯Àªº±µ¨ü¾¹¡C¬Y¨Ç°©²Ó­M¤]¥i¥H±N¤@¨Ç«eÁͪ«½è¥NÁÂÂà´«¦¨teststerone©ÎDHT¡C³o¨Ç¶¯©Ê¯À¥i¥H§í¨î°©½èªº³Q§l¦¬¡C¥Ø«e¦³Á{§É¬ã¨sµo²{¡A±N2.5mgªº¥Ò°ò¤Æ¶¯©Ê¯À¡]methyltestosterone¡^¦X¨Ö»Û¿E¯À§MÀø¡A¥i¥H¦³®Ä¦a´£¤É°©±K«×¡C¶¯©Ê¯À¹ï©ó°©½èªº¥¿­±¼vÅT¡A¤]¥i¥H±q¨k©Ê¸û¤Ö¦³°©½è²¨ÃP¯gªº¹ê»Ú±¡§Î±o¨ìµý¹ê¡C¦ý¬O¥H¹ê»ÚªºÁ{§É¹B¥Î¦Ó¨¥¡A¶¯©Ê¯ÀÁÙ¬O«O¯dµ¹ÄY­«°©½è²¨ÃP¡]osteopenia¡^ªº¯f¤H¡A©Î¬O¹³¿©±w·R´þ¯fªø´Á¯Ê¤Ö¦Ù¦×¹B°Ê¦Ó¾É­P°©½è²¨ÃPªº¤H¡C

¯Ê¥F¶¯©Ê¯À®É©Ò¦ñÀHªº¯gª¬

´ú¶q¶¯©Ê¯Àªº¿@«×¨Ã¤£¹³´ú¶q¨ä¥¦¦å²G¤¤ªº²üº¸»X¦]¤l¨º»ò®e©ö¡C³Ì¥D­nªº­ì¦]¬O°ü¤k¶¡¶¯©Ê¯ÀªºÅܲ§©Ê«Ü¤j¡A¦]¦¹­n©w¸q¤@­Ó°ü¤k¬O§_³B¦b¯Ê¥F¶¯©Ê¯Àªºª¬ªp¤]Åܱo«D±`¦a§xÃø¡C¤@¯ëÁ{§ÉÂå®v©w¸q¶¯©Ê¯À¯Ê¥F¡A¬O±Ä¥Î¡u¬Û¹ï¡v©Ê¶¯©Ê¯À¯Ê¥F§@¬°¶EÂ_·Ç«h¡C¯­¦³±µ¨üÂù°¼§Z±_¤Á°£ªº°ü¤k¡AÁ{§ÉÂå®v¤~¥i¥H¦Ê¤À¤§¦Ê¦a¤U¯Ê¥F¶¯©Ê¯Àªº¶EÂ_¡C¨ä¥¦·|²£¥Í¶¯©Ê¯À¯Ê¥Fªº±¡ªp©|¥]¬A¡G°I¦Ñ¡B¸£¤U««Åé¾÷¯à§C¤U¡BµÇ¤W¸¢°IºÜ¤ÎªA¥Î·|¼W¥[©Ê²üº¸»Xµ²¦X³J¦Ê²y¡]SHBG¡^ªºÃĪ«¡C

¥~·½©Ê¶¯©Ê¯Àªº¨Ï¥Î

¥Ø«e¥~·½©Ê¶¯©Ê¯ÀªºÃÄ«~·U¨Ó·U¦h¡A¦³¦Ù¦×ª`®gªº¡B¥Ö¤U´Ó´Xªº¡B¤fªA©Î¥Ö½§¥~¥Îªº¾®½¦¡CÁöµM¦Ù¦×ª`®gªº¹ï©ó±µ¨üÂù°¼§Z±_¤Á°£ªº°ü¤k¬Û·í¦³®Ä¡A¦ý¹ï©ó¤@¯ë¤H«h¤£«Øij¨Ï¥Î¡A¦]¬°¦³Ãþ©T¾J§y¿nªº¦MÀI©Ê¡C

¥~·½©Ê¶¯©Ê¯Àªº¦MÀI¤Î°Æ§@¥Î

¥~·½©Ê¶¯©Ê¯Àªº¦MÀI¤Î°Æ§@¥Î¤j­P¥i¤À¬°¤TÃþ¡C¤fªA¥~·½©Ê¶¯©Ê¯À¡]Methyltestosterone¡^¹ï©ó¤ßŦ¦åºÞ¤è­±¤]¦³¬Y¨Ç¤£¦Pµ{«×ªº¥¿­±©Î­t­±ªº¼vÅT¡C¥¦·|¨ÏHDL­°§C20%¡A¹ï©óLDL¤]¦³­°§Cªº®ÄªG¡C­P©ó¤T»Ä¤zªo¯×¤è­±¬ù¥i­°§C15%¡C¹ï©ó«aª¬°Ê¯ßªº¼vÅT¥Ø«e©|µL©w½×¡C¥t¥~Á{§É¬ã¨s¥Ø«e©|¥½µo²{¡A¨Ï¥Î¥~·½©Ê¶¯©Ê¯À·|¼W¥[¨ÅÀù©Î¤l®c¤º½¤Àùªº¾÷²v¡C

µ²½×

²{¦b¥«­±¦³³\¦h§t¦³¶¯©Ê¯Àªº°·±d­¹«~¡A¦Ó¥B¥~·½©Ê¶¯©Ê¯ÀªºÂå¥ÎÃÄ«~¤]³vº¥¼W¥[¡C¦b¡u·R¬ü¬O¤k¤Hªº¤Ñ©Ê¡v¤Î§Ü°I¦ÑÂå¾Ç¤é¯q¿³²±ªº¤µ¤é¡A³\¦h°ü¤k¹ï©óÁ{§ÉÀø®Ä¬ã¨s¬Û·í²M·¡ªº»Û¿E¯À¸É¥RÀøªk¤Ï¦Ó©Ä¨B¡AÂà¦Ó´M¨D¨ä¥Lªº¥tÃþÀøªk¡C¶¯©Ê¯À¸É¥RÀøªk´N¬O¨ä¤¤±`³Q¨Ï¥Îªº¤@ºØÀøªk¡C¦]¦¹¨­¬°Á{§ÉÂåÀø¤H­ûÀ³¸Ó¥R¤ÀÁA¸Ñ¶¯©Ê¯À¸É¥RÀøªkÀuÂI¡A¤Î¨ä¹ï¤HÅé©Ò¼çÂ꺦MÀI©Ê¡C¥Ø«e¶¯©Ê¯À¸É¥RÀøªk¦bÁ{§É¨Ã©|¥½¼sªx¦a¥Î¨Ó§MÀø§ó¦~´Á¯g­Ô¸s¡C³Ì¥D­nªº­ì¦]¬OÁ{§É¸ÕÅç©|¥½Àò±o¦@¦P¤@­P©Êªºµ²½×¡A¦Ó¥B¤]¤í¯Ê¤j³W¼Òªø´Áªº°lÂܬã¨s¡A¦pWHI¹ïpremarinªºÁ{§É¸ÕÅç¡C¦]¦¹¨Ï¥Î¶¯©Ê¯À¸É¥RÀøªk®ÉÀ³¸Ó·V¿ï¯f¤H¡A¨Ã¥B§iª¾¨ä¦w¥þ©Ê¤Î¦MÀI©Ê¡A¸Ô²Óµû¦ô¯f¤H¦b¨Ï¥Î«áªº±¡ªp¡A¤~¥i¥H±o¨ìÀ³¦³ªºÀø®Ä¡C­Y¦A¹L´X¦~«á¡A¦h¼Æ¤j³W¼Òªø´ÁªºÁ{§É¸ÕÅç¡A¯à°÷Àò±o¤@­P©Êªºµ²½×Åã¥Ü¶¯©Ê¯À¸É¥RÀøªk½T¹ê¦³¥¿­±ÂåÀø»ù­È¡A¨º»ò¶¯©Ê¯À¸É¥RÀøªk©Î³\¥i¥H¦¨¬°¡uCinderella of the hormonal ball¡v¡C¦ý¬O¦b¤@¤Á©|¥½©ú®Ô¤Æ¤§«e¡A¨Ï¥Î¤WÁÙ¬O¤p¤ß¬°©y¡C

 
1