Dalhousie University Department of Urology, Halifax, NS, Canada.
McGill University Department of Urology, Montreal, QC, Canada.
Int J Impot Res. 2022 Nov;34(7):693-697. doi: 10.1038/s41443-021-00509-5. Epub 2022 Jan 6.
Secondary erythrocytosis is one of the most common adverse events associated with testosterone therapy (TT). Upon encountering this, clinicians will often either adjust TT dosing, stop therapy, order a phlebotomy, or recommend a combination of these. Despite this, the evidence for secondary polycythemia causing harm during TT is scarce, and the hematocrit-based cutoffs present in multiple guidelines appear to be arbritrarily chosen. In this review, we present the pathophysiology behind TT and secondary erythrocytosis, the evidence connecting TT, secondary erythrocytosis and major adverse cardiovascular events (MACE), and the data supporting varying interventions upon diagnosis of secondary erythrocytosis.
继发性红细胞增多症是与睾酮治疗（TT）相关的最常见不良反应之一。遇到这种情况，临床医生通常会调整 TT 剂量、停止治疗、进行放血或建议综合应用这些方法。尽管如此，TT 期间继发性红细胞增多症导致危害的证据很少，并且多个指南中基于血细胞比容的切点似乎是任意选择的。在这篇综述中，我们介绍了 TT 和继发性红细胞增多症背后的病理生理学、TT、继发性红细胞增多症和主要不良心血管事件（MACE）之间的关联证据，以及诊断继发性红细胞增多症时支持各种干预措施的数据。
