COPD合并勃起功能障碍的调查研究

Investigation of erectile dysfunction in patients with chronic obstructive pulmonary disease

目的研究COPD患者合并勃起功能障碍(ED)的发生率。方法对顺序纳入2010年7月～2012年7月宁德市医院门诊就诊的符合入选标准的男性COPD稳定期患者86例进行临床评估,年龄44～70岁,平均(62.28±6.44)岁;同时选取相匹配的对照组30名。所有受试者均进行肺功能测定[包括用力肺活量(FVC%)、第一秒用力呼气容积(FEV1%)、一秒率(FEV1/FVC%)和一氧化碳弥散量(DLco%)]、6分钟步行试验(6MWT)、指端血氧饱和度测定(SaO2)和血清性激素[血清睾酮(T)和雌二醇(E2)水平]检测,同时通过回答国际勃起功能指数-5(IIEF-5)问卷来诊断和评估ED。结果 COPD组总的ED发病率70%,对照组67%。与对照组相比,COPD组血清睾酮水平明显降低[分别为(4.63±1.70)和(3.57±1.52)],而血清雌二醇水平差别无统计学差异[分别为(25.45±8.35)和(22.95±6.17)]。相比对照组,COPD组中、重度ED的发生率更高[分别为14%和42%],并且ED的分值更低、程度更重[ED分值分别为(17.91±7.90)和(12.66±8.44);ED程度值分别为(2.53±1.49)和(1.66±0.71)]。COPD组ED的分值与年龄无相关性,但与吸烟、病程、6MWD、FEV1%、DLco、SaO2、T指标相关,且均有统计学意义。结论 COPD患者较同年龄的健康对照组ED的发生更加频繁且严重,对COPD综合评估和管理时应引起重视。

Objective To investigate the erectile dysfunction in patients with COPD. Methods 86 male patients with COPD were selected in this study, aging from 44 to 70 years old, with an average of 62. 28 ± 6. 44. 30 healthy people were taken as controls. Their lung function were detected, including FVC%, FEV1%, FEV1/FVC%, DLco%, 6MWT, SaO2 and T and E2. They were asked to answer the International Index of Erectile Func-tion 5 （IIEF-5） questionnaire as a method to diagnose and classify ED. Results The serum level of testosterone in the COPD group was lower than that in the control group, but the serum level of estradiol showed no significant differ-ence between the two groups. The incidence of ED was obviously higher in the patients with moderate and severe COPD than others. The score of ED of COPD patients was not correlated with age and estradiol levels, but correlated with smoking burden, duration of COPD, FEV1%, DLco, SaO2, 6MWD and testosterone level. Conclusion The present study shows that ED is frequent and more severe in COPD patients than age-matched controls. Patients with COPD need comprehensive management including a detailed sexual evaluation.