肾移植与血液透析治疗对尿毒症患者阴茎勃起功能影响的临床对照研究

Penile erectile function in renal transplant recipients and uremic men undergoing hemodialysis: A clinical control study

目的:研究对比男性尿毒症患者接受肾移植与接受血液透析治疗勃起功能的变化及与生殖激素水平变化的关系。方法:收集2009年5月至2012年1月在我院门诊进行随访的肾移植男性患者35例、血液透析治疗的尿毒症患者30例,应用国际勃起功能指数(IIEF-5)调查表、夜间勃起功能(NEVA)测定仪评估阴茎勃起功能,同时测定生殖激素水平。结果:接受肾移植手术者勃起功能障碍(ED)患病率为51.4%,血液透析者ED患病率为73.3%(P<0.05);肾移植后的ED患者发病情况要明显轻于单纯血液透析的ED患者;肾移植中重度ED患者(25.7%)要明显少于单纯血液透析者(46.6%);肾移植组中ED患者夜间阴茎勃起次数、勃起强度及持续时间均强于单纯血液透析组ED患者(P<0.05);接受肾移植患者较单纯血液透析血清睾酮水平上升[(4.32±1.37)vs(2.53±1.12)ng/ml,P<0.05],雌二醇[(19.57±2.29)vs(43.38±5.58)pg/m)]和催乳激素[(8.59±1.19)vs(17.22±3.31)mIu/ml]明显下降(P均<0.05)。结论:肾移植受者肾功能良好时其总体勃起功能要优于单纯血液透析的尿毒症患者。

Objective： To observe the changes in penile erectile function and levels of serum sex hormones in renal transplant recipients and uremic men undergoing hemodialysis.Methods： We analyzed the follow-up data of 35 male renal transplant recipients and 30 uremic men undergoing hemodialysis.We assessed the penile erectile function of the patients using IIEF-5 questionnaire and nocturnal electrobioimpedance volumetric assessment（NEVA）,and determined the levels of serum sex hormones.Results： The incidence rate of erectile dysfunction（ED） was 51.4% in the renal transplant recipients,and 73.3% in the uremic men undergoing hemodialysis（P〈0.05）.The cases of moderate to severe ED accounted for 25.7% in the renal transplantation group,and 46.6% in the hemodialysis group.The renal transplant recipients showed a higher nocturnal erectile frequency,better erectile hardness and longer erectile duration than those undergoing hemodialysis（P〈0.05）.The level of serum testosterone（T） was markedly higher while the levels of estradiol（E2） and prolactin（PRL） significantly lower in the former than in the latter（T： [4.32±1.37] vs [2.53±1.12] ng/ml,P〈0.05;E2： [19.57±2.29] vs [43.38±5.58] pg/m,P〈0.05;PRL： [8.59±1.19] vs [17.22±3.31] mIu/ml,P〈0.05）.Conclusion： Renal transplant recipients with normal renal function have a better overall penile erectile function than uremic men undergoing hemodialysis.