Madaeva I M, Berdina O N, Semenova N V, Madaev V V, Rychkova L V, Kolesnikova L I
Scientific Сentre for Family Health and Human Reproduction Problems, Irkutsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(4. Vyp. 2):79-83. doi: 10.17116/jnevro20171174279-83.
Obstructive sleep apnea syndrome (OSAS) is a common disease that causes a different spectrum of life processes violations in the continuum of 'sleep-wakefulness'. OSAS in combination with age-specific hypogonadism as a systemic pathology requires certain interdisciplinary approaches involving both the correction of the obstruction, and testosterone therapy in men with hypogonadism.
Assessment of the effect of combined use of CPAP (Continuous Positive Airway Pressure) and testosterone replacement therapy (transdermal form - Androgel) on indicators of polysomnography monitoring (PSG) with simultaneous study of erectile function and testosterone secretion.
26 men with OSAS and andropause (mean age - 46,1±8,4 years, BMI - 35,2±4,6 kg/m2) were examined. All patients were divided into 2 groups: men with therapy CPAP (n=14); men with combination therapy CPAP and Androgel (50 mg 1 times a day) (n=12). CPAP was carried out by automatic apparatus: Prisma 20A ('Weinemann', Germany) and iSleep 20i ('Breas', Sweden). Duration of therapy in both groups was 2 months.
There were no statistically significant differences in the baseline characteristics of the physical examination, the level of total testosterone, PSG and nocturnal penile patterns in both groups of patients. After combination therapy (CPAP and Androgel) in men found the increase of total testosterone levels by 2 times (p<0,05) and improvement in indicators of altered nocturnal penile erection episodes (Tup, Tmax, Tm/R, Tup/R, the total number of NPT (p<0,05)) compared with similar parameters in men with only on CPAP-therapy was found. Indicators of the objective status were improved, although there were no changes in PSG characteristics in both groups.
The results of this study indicate greater efficiency of the combined method of treatment (CPAP+Androgel) in patients with OSAS and andropause.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见疾病，在“睡眠 - 觉醒”连续过程中会导致不同程度的生命过程紊乱。OSAS与特定年龄的性腺功能减退作为一种全身性病理状况，需要某些跨学科方法，包括纠正阻塞以及对性腺功能减退男性进行睾酮治疗。
评估持续气道正压通气（CPAP）与睾酮替代疗法（透皮制剂 - 安特尔）联合使用对多导睡眠图监测（PSG）指标的影响，同时研究勃起功能和睾酮分泌。
对26名患有OSAS和男性更年期的男性（平均年龄 - 46.1±8.4岁，体重指数 - 35.2±4.6kg/m²）进行检查。所有患者分为2组：接受CPAP治疗的男性（n = 14）；接受CPAP与安特尔联合治疗（每日1次，50mg）的男性（n = 12）。CPAP通过自动设备进行：Prisma 20A（德国“万曼”）和iSleep 20i（瑞典“博雅”）。两组治疗持续时间均为2个月。
两组患者的体格检查基线特征、总睾酮水平、PSG和夜间阴茎勃起模式方面，均无统计学显著差异。在接受联合治疗（CPAP和安特尔）的男性中，发现总睾酮水平增加了2倍（p<0.05），与仅接受CPAP治疗的男性相比，夜间阴茎勃起次数改变的指标（Tup、Tmax、Tm/R、Tup/R、夜间阴茎勃起总数（p<0.05））有所改善。客观状态指标有所改善，尽管两组的PSG特征均无变化。
本研究结果表明，联合治疗方法（CPAP + 安特尔）对患有OSAS和男性更年期的患者更有效。
