心血管疾病患者并发勃起功能障碍的危险因素分析

Risk factors of erectile dysfunction in patients with cardiovascular diseases

目的：调查男性心血管疾病住院患者的勃起功能,探讨心血管疾病中勃起功能障碍（ED）的发生率及其危险因素与勃起功能的关系。方法：自行设计问卷,对西安交通大学第一、第二附属医院心血管内科住院的男性患者进行问卷调查,测量身高、体重、腰围、臀围、血压等数据;收集个人基本信息、既往史（包括吸烟史、饮酒史,高血压、冠心病、心律失常、心绞痛、心肌梗死病史、糖尿病病史等）,记录代谢参数检查结果。同时以IIEF-5进行勃起功能评分。采用单变量、多变量Logistic回归分析及比值比（OR）确定ED的危险因素。结果：本研究共纳入有效问卷225份,经统计分析发现在整个调查人群中ED的发病率为66.7%。其中轻度、轻中度、中度、重度ED的发病率分别为15.8%、27.0%、17.6%、6.3%。各组别（18～35岁、36～49岁、50～65岁、〉65岁）人群ED的发病率分别为13.6%、39.1%、89.2%、91.2%。单变量Logistic回归显示,心血管疾病并发ED的危险因素包括年龄（OR=3.122,95%CI：2.040～4.779）、吸烟（OR=1.768,95%CI：1.209～2.584）、BMI（OR=1.261,95%CI：1.114～1.427）、总胆固醇（OR=1.77,95%CI：1.339～2.34）、TC/HDL（OR=1.715,95%CI：1.349～2.181）、高血压（OR=1.717,95%CI：1.110～2.658）及冠心病（OR=2.235,95%CI：1.169～4.275）。而多变量Logistic回归分析显示,心血管疾病并发ED的危险因素分别为年龄（OR=4.99,95%CI：2.264～10.998）、经济情况（OR=2.804,95%CI：1.127～6.976）、吸烟（OR=2.109,95%CI：1.179～3.772）、BMI（OR=1.414,95%CI：1.136～1.76）和TC/HDL（OR=2.001,95%CI：1.016～3.943）。结论：在我国心血管疾病男性住院患者中ED的发病率很高,并随着年龄的增长而升高。年龄、吸烟、经济情况、BMI、TC/HDL是ED的危险因素,心血管病与ED存在着共同的危险因素,包括年龄、吸烟、BMI、TC/HDL,而经济情况在研究中被证实与ED关系密切,为以后的研究提供了新的思路。

Objective： To investigate the penile erectile function of hospitalized male patients with cardiovascular diseases,the incidence of erectile dysfunction（ ED） in this cohort,and the relationship of ED with cardiovascular diseases and its risk factors.Methods： Using a self-designed questionnaire,we conducted an investigation among the hospitalized patients in the Department of Cardiovascular Diseases of the First and Second Affiliated Hospitals of Xian Jiaotong University. We measured their body height,body mass index（ BMI）,waist circumference,hip circumference,and blood pressure,obtained their personal data,past history,metabolic indexes,and erectile function scores by IIEF-5,and analyzed the risk factors of ED using univariate and multivariate logistic regression and OR analyses. Results： Totally,225 valid questionnaires were included in this investigation,which showed a 66. 7% incidence of ED,15. 8% mild,27. 0% mild to moderate,17. 6% moderate,and 6. 3% severe. The incident rates of ED in the 18- 35 yr,36-49 yr,50- 65 yr,and 65 yr age groups were 13. 6%,39. 1%,89. 2%,and 91. 2%,respectively. Univariate logistic regression analysis manifested that the risk factors of ED in the patients with cardiovascular diseases included age（ OR = 3. 122,95% CI 2. 040-4. 779）,smoking（ OR = 1. 768,95% CI 1. 209- 2. 584）,BMI（ OR = 1. 261,95% CI 1. 114- 1. 427）,total cholesterol（ OR =1. 77,95% CI 1. 339- 2. 340）,TC / HDL（ OR = 1. 715,95% CI 1. 349- 2. 181）,hypertension（ OR = 1. 717,95% CI 1. 110-2. 658）,and coronary heart disease（ OR = 2. 235,95% CI 1. 169- 4. 275）,while multivariate logistic regression analysis showed the risk factors to be age（ OR = 4. 99,95% CI 2. 264- 10. 998）,financial condition,（ OR = 2. 804,95% CI 1. 127- 6. 976）,smoking（ OR = 2. 109,95% CI 1. 179- 3. 772）,BMI（ OR = 1. 414,95% CI 1. 136- 1. 760）,and TC/HDL（ OR = 2. 001,95% CI 1. 016- 3. 943）. Conclusion： The incidence of ED is high in hospitalized patients with cardiovascular diseases and rises with the increase of age. Age,smoking,financial condition,BMI,and TC / HDL are the risk factors of both ED and cardiovascular diseases,and financial condition is closely associated with ED.