性视频刺激加5型磷酸二酯酶抑制剂激发阴茎勃起实验在勃起功能障碍诊治中的应用

Type V Phosphodiesterase Inhibitor Erection-provoking Test with Audio-visual Sexual Stimulation for the Diagnosis of Erectile Dysfunction

目的:探讨性视频刺激加5型磷酸二酯酶(PDE5)抑制剂激发阴茎勃起实验在勃起功能障碍(ED)诊治中的应用价值,以指导ED的诊断和治疗。方法:收集门诊ED患者853例,分为损伤和非损伤两组,先应用国际勃起功能评分5问卷表(IIEF-5)评分,口服PDE5抑制剂30min后再予性视频刺激,通过阴茎硬度监测仪实时监测阴茎勃起。结果:损伤组中轻度、中度和重度ED患者分别占18.8%、31.9%、49.3%,非损伤组中分别占50.6%、39.8%、9.6%,两组患者轻、重度ED的比例差异有显著性(P<0.05);性视频刺激加PDE5抑制剂激发阴茎勃起实验结果损伤组中显效、有效和无效分别占13.0%、14.5%、72.5%,总有效率为27.5%,而非损伤组中分别占55.7%、20.7%、23.6%,总有效率为76.4%,两组患者总有效率比较有统计学意义(P<0.05)。结论:利用性视频刺激加PDE5抑制剂激发阴茎勃起实验鉴别心理性ED和器质性ED,方法简单,实用,准确性高,可作为ED的初筛试验,值得推广应用。

Objective： To evaluate the type V phosphodiesterase （PDE-5）inhibitor erection-provoking test with audio-visual sexual stimulation in the diagnosis of erectile dysfunction. Methods ： A total of 853 out-patients diagnosed with erectile dysfunction were divided into an injury and a non-injury group. After scored on IIEF-5 questionnaires, all the patients received oral administration of PDE- 5 inhibitors and, 30 minutes later, audio-visual sexual stimulation. The data on penile erection were recorded with Rigiscan Plus. Results： The patients with mild, moderate and severe ED accounted for 18.8, 31.9 and 49.3 % in the injury group, and 50.6, 39.8 and 9.6% in the non-injury group, with statistic differences between the two groups in the mild and severe parts （ P 〈 O. 05 ）. The rates of conspicuous effectiveness, effectiveness, ineffectiveness and total effectiveness of the combined method were 13. 0, 14.5, 72.5 and 27.5 % in the injury group, but 55.7, 20.7, 23.6 and 76.4% in the non-injury group, with significant differences （P 〈 O. 05）.Conclusion： The PDE-5 inhibitor erection-provoking test with audio-visual sexual stimulation is a simple, practical, safe and effective method for the differentiation of organic from psychological erectile dysfunction.