比较血液透析与肾移植对男性性关系、勃起功能及性激素水平的影响

Comparative analysis of sexuality,erectile function and sexual hormone levels in male patients of hemodialysis and kidney transplantation

目的对比研究男性血液透析与肾移植患者在性关系、勃起功能及性激素水平的变化情况。方法以2011年1月至2015年6月于河南中医学院第一附属医院行血液透析及肾移植的男性患者为研究对象,分为血液透析(hemodialysis,HD)组、肾移植(kidney transplantation,KT)组,分别观察分析两组在性关系(relationship and sexuality,RS)评分、国际勃起功能(international index of eretile function 5,IIEF-5)评分及性激素的不同变化情况。其中RS评分又包括性功能、性恐惧及性频率3个亚项;性激素包括睾酮(testosterone,T)、催乳素(prolactin,PRL)、雌二醇(estradiol,E2)、卵泡刺激素(follicle-stimulating hormone,FSH)和黄体生成素(1uteinizing hormone,LH)。结果与HD组相比:KT组在RS评分及各亚项单独评分方面均降低(P<0.05):IIEF-5评分升高(P<0.05);KT组患者的T水平高于HD组(P<0.05),PRL及E_2水平明显降低(P<0.05),两组的FSH、LH水平均无显著(P>0.05)。结论男性肾移植患者在性关系、勃起功能方面优于透析患者,推测原因为肾移植能够在一定程度上改善患者的性激素失衡状态。

Objective To comparative analyze changes in the levels of sexuality, erectile function and sexual hormone in male patients ofhemodialysis and kidney transplant. Methods Total of 76 hemodialysis patients and 70 kidney transplant patients were divided into 2 groups such as hemodialysis （HD） Group and kidney transplant （KT） Group. Relationship and sexuality （RS） score, international index of eretile function 5 （IIEF-5） score and sexual hormone levels were investigated. The RS score consists of sexual relationship function score, sexual relationship frequency score and sexual relationship fear score. Level of serum testosterone （T）, prolactin （PRL）, estradiol （E2）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were examined. Results The patients of kidney transplant showed a better overall RS score compared with the hemodialysis group （P〈0.05）, and all subscales including sexual function, sexual frequency, and sexual fear （P〈0.05,respectively）. In comparison with that of HD group, levels of T increased in KT Group （P〈0,05）, whereas levels of PRL and E2 decreased significantly （P〈0.05）. In addition, levels of FSH and LH had no difference between two groups （P〉0.05）. Conclusion The patients of kidney transplant showed a better sexuality ability and erectile function. We speculated that recovery of sex hormone homeostasis after kidney transplantation account for it.