外周动脉张力测定对男性ED患者血管内皮功能的研究

Study of the peripheral arterial tonemetry on vascular endothelial function in male ED patients

目的采用外周动脉张力（PAT）指数评价男性勃起功能障碍（ED）患者血管内皮功能情况，探讨ED患者血管内皮功能紊乱的影响因素。方法采用内皮功能监测仪Endo．PAT，测定连续入选的87名男性ED患者（22～53岁）的PAT指数，将PAT指数≥1．67的患者列为血管内皮功能正常组，PAT指数〈1．67的患者列为血管内皮功能紊乱组，按照国际糖尿病联盟提出代谢综合征（MS）的诊断标准（IDF2005）要求行体格检查、血脂和空腹血糖检查，进行国际勃起功能评分5项（IIEF-5）和性激素三项（T、PRL、Ez）检查。结果87名ED患者平均年龄（33．8±7．2）岁，血管内皮功能紊乱患者52名，血管内皮功能正常患者35名，血管内皮功能紊乱组与正常组比较，体质量、腰围、空腹血糖水平升高（P〈0．05），胆固醇、甘油三脂显著升高（P〈0．01），而高密度脂蛋白降低（P〈0．05），在内皮功能紊乱的ED患者中，Ms患者22例，血管内皮功能正常的ED患者中，MS患者7例，血管内皮功能紊乱组MS发病率明显升高（P〈0．05），血管内皮功能与性激素三项（T、E2、PRL）无显著相关（P〉0．05）。其次，与血管内皮功能正常组比较，血管内皮功能紊乱组患者ED病情更重（P〈0．05）。结论ED患者中血管内皮功能紊乱者MS显著升高，中心性肥胖、高脂血症、糖尿病是构成ED患者血管内皮功能紊乱的主要危险因素，血管内皮功能紊乱组患者ED病情更重。

Objective To evaluate the vascular endothelial function of patients with erectile dysfunction using Peripheral Arterial Tone （PAT）, and analyze the related factors to the vascular endothelial dysfunction. Methods The endothelial function of 87 ED patients was measured by EndoPAT2000. The test was carried out on two separate finger tips. The endothelial function was evaluated by PAT ratio of the finger tip. And ED patients were investigated by physical examination, lipid metabolism, fasting plasma glucose, sexual hormones （testosterone[T], estradiol[E2], prolactin[P]） and International index of erectile function 5（IIEF-5）. The clinical diagnostic criteria of metabolic syndrome （MS） was in accordance with the 2005 International Diabetes Federation （IDF2005） issued by the international academic community. Results Average age of 87 ED patients was 33.8＋7.2 years-old, including 52 with endothelial dysfunction and 35 with normal endothelial function. Fasting plasma glucose （FPG）, waist circumference and weight levels of patients in vascular endothelial dysfunction group were significantly higher than the patients in non-vascular endothelial dysfunction group （P〈0.05）, and total cholesterol（TC） and triglyceride （TG） were also significantly higher （P〈0.01）, while high density lipoprotein （HDL） was significantly lower （P〈0.05）, but blood pressure, low density lipoprotein （LDL）, T, E2 and PRL had no difference （P〉0.05）. Secondly, the prevalence of MS in vascular endothelial dysfunction with ED group was 42.3%, which was significantly higher than 20% in non-vascular endothelial dysfunction with ED group （P〈0.05）. Secondly, compared with normal endothelial function, the patients with endothelial dysfunc- tion were much severer （P〈0.05）. Conclusion The prevalence of MS in ED patients with vascular endothelial dysfunction was significantly higher. Central obesity, hyperlipidemia and diabetes mellitus were the major risk fac- tors for endothelial dysfunction. And erectile function in patients with endothelial dysfunction might be even worse.