小结
定义
病史和体格检查
关键诊断因素
- 性欲减退
- 自发晨勃的减少
- 勃起功能障碍
- 男性乳房发育
- 不育症
- 溢乳
- 小阴茎
- 小睾丸
- 阴囊分裂
- 隐睾症
- 类无睾症比例
- 两颞测偏盲
- 轻度创伤性骨折
- 身高减少
- 嗅觉丧失
其他诊断因素
- 体力降低以及容易疲劳
- 青春发育延迟
- 阴囊色素沉着以及褶皱的缺失
- 肌肉质量及力量的减少
- 腋毛和阴毛脱落
- 胡须减少
- 注意力以及记忆力较差
- 情绪低落
- 睡眠障碍
- 潮热及盗汗
- 体重指数（BMI）增加
- 身材高大
- 面部皱纹
危险因素
- 遗传性疾病
- 2型糖尿病
- 使用烷化剂、阿片类药物或糖皮质激素
- 外源性性激素及GnRH类似物的应用
- 高催乳素血症
- 垂体肿瘤或卒中
- 重大疾病
- 睾丸损伤
- 精索静脉曲张
- 自身免疫性睾丸损伤
诊断性检查
首要检查
- 血清总睾酮
需考虑的检查
- 性激素结合球蛋白（SHBG）
- 血清游离睾酮
- 血清生物可利用睾酮
- 血清黄体生成素（LH）或卵泡刺激素（FSH）
- 血清催乳素
- 血清铁、总铁结合量以及铁蛋白
- 垂体 MRI 检查
- 精液分析
- 基因检测
- 血清 TSH
- 双能 X 线吸收测量（DEXA 或 DXA）
治疗流程
原发性
继发性
撰稿人
作者
Charles Welliver, MD
Assistant Professor of Surgery
Division of Urology
Albany Medical College
Albany
NY
利益声明
CW has worked as a consultant for Coloplast, and as an investigator for Auxilium Pharmaceuticals, Mereo BioPharma, PROCEPT BioRobotics, and Repros; and he is a paid reviewer at Oakstone Publishing and BMJ Best Practice. CW also has a family member who is an employee at Bristol-Myers Squibb.
鸣谢
Dr Charles Welliver would like to gratefully acknowledge Matthew Aoun for his help with updating this topic. He would also like to acknowledge Dr T. Hugh Jones, Dr Milena Braga-Basaria, and Dr Shehzad Basaria, previous contributors to this monograph. THJ and SB are authors of references cited in this topic. MB declared that she had no competing interests.
同行评议者
Randal J. Urban, MD
Professor
Department of Internal Medicine
University of Texas Medical Branch
Galveston
TX
利益声明
RJU declares that he has no competing interests.
Niki Karavitaki, MBBS, MSc, PhD
Consultant Endocrinologist
Oxford Centre for Diabetes, Endocrinology and Metabolism
Churchill Hospital
Oxford
UK
利益声明
NK declares that she has no competing interests.
鉴别诊断
- 垂体巨腺瘤
- 催乳素瘤
- 高催乳素血症
更多 鉴别诊断指南
- 成年男性雄激素缺乏综合征可利用睾酮替代疗法治疗
- 男性不育症指南
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