肾移植前后绝经期前成年女性性功能评估

Sexual function in premenopausal women before and after renal transplantation

目的研究绝经期前成年女性肾移植前、后的性功能改变。方法 42例成年已婚女性、透析治疗超过6个月、肾移植术后肾功能恢复正常超过6个月的女性肾移植受者纳入研究。统计肾移植前后月经周期情况、检验患者手术前后性激素水平。采用女性性功能指数(FSFI)量表分别评估术前、术后患者的性功能。结果肾移植前闭经、月经稀发、月经频发及月经正常的患者分别有18例(42.9%)、10例(23.8%)、5例(11.9%)、9例(21.4%),移植后分别为7例(16.7%)、5例(11.9%)、6例(14.3%)、24例(57.1%)。肾移植后催乳素(PRL)、卵泡刺激素(FSH)及黄体生成素(LH)较肾移植术前明显降低,而雌二醇(E2)和孕酮(P)较术前升高(P<0.001)。移植前19例(45.2%)、术后36例(85.7%)受者有性生活(P<0.001)。肾移植前、后女性性功能障碍(FSD)的总发病率分别为90.5%、40.5%(P<0.001)。肾移植前FSFI评分中性欲、性唤起、阴道润滑、性满意度、性高潮及性交痛领域的分值显著低于肾移植后(P<0.001)。结论肾移植术后肾功能恢复正常后成年女性受者的性功能能够明显改善。

Objective To study the changes in sexual function in premenopausal women after renal transplantation. Methods Forty-two married premenopausal women receiving dialysis therapy for at least 6 months with normal renal function for 6 months after renal transplantation were examined for hormonal profiles and menstrual cycles. The sexual fimctions of the patients were evaluated using Female Sexual Function Index （FSFI） before and 6 months after the transplantation. Results Before renal transplantation, amenorrhea, oligomenorrhea, polimenorrhea, and eumenorrhea were found in 18 cases （42.9%）, 10 cases （23.8%）, 5 cases （11.9%） and 9 cases （21.4%）, as compared to 7 cases （16.7%）, 5 cases （11.9%）, 6 cases （14.3%） and 24 cases （57.1%） after the transplantation, respectively. Prolactin （PRL）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） levels significantly decreased and estradiol （E2） and progesterone （P） significantly increased after renal transplantation （P〈0.001）. Nineteen patients （45.2%） before and 36 patients （85.7%） after the surgery reported to have an active sexual life （P〈0.001）. The total incidences of female sexual dysfunction before and after kidney transplantation were 90.5% and 40.5% （P〈0.001）, respectively. The scores for sexual desire, arousal, lubrication, satisfaction, orgasm, and pain in FSFI were significantly increased after kidney transplantation （P〈0.001）. Conclusion A successful renal transplantation can significantly improve sexual functions in premenopausal women.