持续气道正压通气治疗老年OSAS患者勃起功能障碍

Treatment for erectile dysfunction of the male elderly with obstructive sleep apnea sydrome by nasal continual positive airway pressure

目的探讨经鼻持续气道正压通气(nCPAP)治疗老年阻塞性睡眠呼吸暂停综合征(OSAS)患者勃起功能障碍(ED)疗效及可能机制。方法选取98例老年男性鼾症患者,采用多导睡眠检测仪(PSG)监测及国际勃起功能评分5项表(IIEF-5)评分,诊断OSAS合并ED患者共30例,随机分为nCPAP治疗组15例和对照组15例。治疗组予呼吸机nCPAP治疗8周,比较两组治疗前后睡眠呼吸暂停指数(AH I)、最低血氧饱和度(LowestSaO2)、IIEF-5评分变化及检测外周血一氧化氮(NO)、血浆内皮素(ET)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果两组患者治疗前AH I、最低SaO2、IIEF-5评分及外周血NO、ET、SOD、MDA水平无明显差异,治疗组在治疗后AH I、最低SaO2、IIEF-5评分比治疗前、对照组明显改善,NO、SOD明显上升,ET、MDA明显下降,差异有统计学意义(P<0.05),而对照组治疗前后上述指标无明显变化(P>0.05)。结论 nCPAP能有效改善老年OSAS合并ED患者勃起功能障碍,能改善血管内皮功能障碍,减轻血管氧化应激,对老年患者是一种安全有效的非手术疗法。

Objective To investigate the effects and mechanism of nasal continual positive airway pressure（nCPAP） on the erectile function of the male erderly with erectile dysfunction（ED） in obstructive sleep apnea syndrome（OSAS）.Methods Thirty male erderly with OSAS complicated ED were diagnosed with polysomnogram（PSG）and the five question International Index of Erectile Function（IIEF-5）.They were randomly divided into treatment（n=15）and control（n=15）groups,the former treated by nCPAP from 22：00 to 6：00 per night for 8 week.And the apnea-hypopnea index（AHI）,the lowest oxygen saturation（SaO2）,IIEF-5 score and the levels of serum nitric oxide（NO）,endothelin（ET）,superoxide dismutase（SOD） and malonaldehyole（MDA） were tested and compared before and after treatment.Results AHI,the lowest SaO2,IIEF-5 score,and the levels of NO,ET,SOD,MDA showed no significant difference before treatment in the two groups,but displayed a significant improvement and higher NO,SOD level,lower ET,MDA level after treatment in the treated group compared with the control（P0.05）,in which no significant changes were observed before and after treatment（P0.05）.Conclusion nCPAP therapy can improve vascular endothelial dysfunction and reduce oxidative stress to improve the erectile function of ED patients with OSAS.It is a safe and effective non-operative treatment method for the male elderly.