心理性勃起功能障碍的下丘脑PET研究

Hypothalamus May Be Involved in Psychogenic Erectile Dysfunction

目的:研究心理性勃起功能障碍(ED)患者下丘脑代谢的改变,以期为心理性ED可能存在的潜在病因和病理生理机制的探讨提供线索。方法:运用正电子发射断层成像(PET)研究6例心理性ED患者和4例年龄匹配的健康志愿者双侧下丘脑的葡萄糖代谢特点,给予视听性刺激,测定脑组织中18F脱氧葡萄糖(18F-FDG)放射强度,计算单位像素内左(右)丘脑计数/全脑总计数。结果:接受视听性刺激后,健康志愿者双侧下丘脑的18F-FDG代谢明显增高(左:1.026±0.115vs2.400±0.210;右:1.003±0.187vs2.389±0.196;P<0.05),而心理性ED患者双侧下丘脑的18F-FDG代谢变化不明显(左:2.781±0.156vs2.769±0.223;右:2.809±0.129vs2.793±0.217,P>0.05)。结论:心理性ED可能不单纯是功能性疾病,下丘脑可能参与了心理性ED的病理生理过程。

Objective：To study the changes of hypothalamus metabolism in patients with psychogenic erectile dysfunction（ED）so as to get some clues to the possible pathogenic factors and pathophysiological mechanism of the problem.Methods：Six cases of psychogenic ED and 4 normal volunteers were studied by positron emission tomography（PET）for the characteristics of hypothalamus glucose metabolism.Following audiovisual sexual stimulation,the concentration of fluorine-18-fluorodeoxyglucose（18^F-FDG）was determined and the ratio of the left（right）hypothalamus count to the cerebrum count was calculated.Results：Audiovisual sexual stimulation significantly increased 18^F-FDG in the volunteers（left：1.026±0.115 vs 2.400±0.210;right：1.003±0.187 vs 2.389±0.196,P〈0.05）as compared with the psychogenic ED patients（left：2.781±0.156 vs 2.769±0.223;right：2.809±0.129 vs 2.793±0.217,P〉0.05）.Conclusion：Psychogenic ED may not be simply a functional disease;the hypothalamus may be involved in the pathophysiology of the problem.