勃起功能分项量表评定神经性勃起功能障碍的效度和信度

Validity and Reliability of Item Erectile Function Scale for Neurogenic Erectile Dysfunction

目的：探讨勃起功能分项量表（I-EF）对神经性勃起功能障碍评定的效度及重测信度和评定者间信度。方法对104例男性脊髓损伤患者采用I-EF进行评分，同时测定患者阴茎神经电生理及夜间阴茎勃起；34例患者治疗后再次测评。对21例中度勃起功能障碍（ED）患者，由两名评定者分别测试1次，2~4周后再测评1次。结果球海绵体肌及阴茎背神经可记录到体感诱发电位者，Q1、Q2评分多≥7分；电活动缺失者，评分为3分。夜间阴茎勃起监测有效勃起1~3次者，Q3评分多≥7分；无有效勃起者，评分为3分。骶上完全组与骶完全组比较，反射性勃起、夜间勃起发生率均较高（P〈0.001）。轻中度ED，治疗后总分提高（P〈0.05）；重度ED治疗前后无显著性差异（P〉0.05）。重测及评定者间等级相关系数（ICC）分别为0.93及0.90。结论 I-EF评分可作为神经性勃起功能障碍评定的可靠指标。

Objective To investigate the validity and reliability of Item Erectile Function Scale （I-EF） for neurogenic erectile dysfunc-tion （ED）. Methods 104 patients with spinal cord injury were assessed with I-EF. They were measured with pudendal somatosensory ner-vous evoked potential （SEP）, bulbocavernosus reflex potential time （BCR） and nocturnal penile tumescence （NPT） detection. 34 patients ac-cepted medicine for ED, and were assessed with I-EF after treatment. 21 patients with medium ED were assessed by 2 testers, and retested 2-4 weeks later. Results The patients who recorded their potential of SEP and BCR got the scores of Q1, Q2 above 7, and the absence with the scores of 3. Those found NPT 1-3 times got the score of Q3 above 7, and the absence with the scores of 3. The incidence of reflex erec-tions and NPT were more in complete suprasacral ones than in complete sacral ones （P〈0.05）. There was significant improvement after med-ication in patients with mild to medium ED （P〈0.05）. The interclass correlation coefficient （ICC） was 0.93 between testers and 0.90 between test-retest. Conclusion I-EF can be used to assess neurogenic erectile dysfunction for rehabilitation.