肾移植患者阴茎勃起功能影响因素分析

Impacts of Kidney Transplantation on Erectile Function and Its Contributing Factors Evaluation

目的:研究肾移植对勃起功能的影响,并对相关影响因素进行分析,以期提高移植术后患者的生活质量。方法:对250例肾移植术后移植肾功能良好的已婚男性受者进行勃起功能国际问卷调查,并收集一般临床资料、病史、性生活史和实验室检查资料。应用单因素分析和多因素Logistic回归分析确定对勃起功能有独立的和显著影响的相关因素。结果:212例完成整个调查,114例移植术前为ED(53.8%),移植术后94例被确定为ED(44.3%),两者差异无显著性(P>0.05)。根据ED分度移植前后的变化,91例(42.9%)勃起功能移植前后无变化,93例(43.9%)有改善,28例(13.2%)移植前勃起功能正常的患者移植后减退。Logistic回归分析确定年龄、贫血、糖尿病、周围神经病变、多次移植是独立和显著影响勃起功能的因素,相对危险度分别为3.01、2.01、3.15、3.89、2.67。结论:肾移植后ED的发生率仍较高。移植术后ED的病因是多方面的,年龄、糖尿病、周围神经病变、血红蛋白水平、多次移植是影响勃起功能的主要因素。

Objective ： To study the impacts of kidney transplantation on erectile function and analyse its contributing factors. Methods ： In order to evaluate the severity of erectile dysfunction （ ED）, a total of 250 married male kidney transplant recipients （KTR） with functioning graft were assessed with the International Index of Erectile Function （IIEF） questionnaire. Data of clinical characteristics, medical and sexual history and laboratory examination were collected. Univariate and multivariate logistic regression analyses were carried out to determine which have independent impacts on erectile function. Results： The investigation was accomplished in 84.8% of the KTRs. There was no significant difference in ED incidence before and after renal transplantation （53.8% vs 44.3%, P 〉 0. 05 ）. According to the IIEF score, erectile function improved in 43.9% of the KTRs, remained unchanged in 42.9% , and deteriorated in 13.2%, as compared with pre -transplantation. Logistic regression analysis showed that significant and independent influencing factors in erectile function were age, hemoglobin level, presence of DM and/or peripheral neuropathy and iterative transplantations, and their relative risks were 3. 01, 2.01, 3.15, 3.89 and 2.67, respectively. Conclusion ： ED is highly prevalent among KTRs and its pathogenesis is muhifactorial. Age, presence of DM and/or peripheral neuropathy, hemoglobin level and iterative transplantations were chief contributing factors in erectile function.