睡眠相关性痛性勃起的诊治对策(附9例报告)

Diagnosis and management of sleep-related painful erections:A report of 9 cases

目的：分析睡眠相关性痛性勃起（SRPE）的病因、发病机制及治疗方法。方法：收集9例SRPE患者,年龄39~59岁,病史（13.5±1.2）个月,均行血常规、尿常规、凝血功能、焦虑与抑郁量表评分、IIEF-5评分、生殖激素、夜间阴茎勃起及多导联睡眠监测,根据各自的病情给予个体化的治疗方案,所有患者均在服药后1、4、8、12及24周各电话随访1次,询问治疗效果及药物的不良反应。结果：9例患者排除其它疾病后均诊断为原发性SRPE,6例采用氯米帕明或氯米帕明＋其他药物联合治疗,3例采用抗雄治疗,4周疼痛完全缓解率为：77.78%,24周疼痛完全缓解率66.67%,3例患者在治疗24周后疼痛复发,根据病情调整治疗方案后1周疼痛消失。结论：氯米帕明或氯米帕明＋其他药物联合治疗及抗雄治疗原发性SRPE,临床效果明显。

Objective： To investigate the pathogenesis and management of sleep-related painful erections（SRPE）. Methods：This study included 9 SRPE patients aged 39- 59（ mean 47. 8） years and with a mean disease course of 13. 5 ± 1. 2 months. We conducted blood urine routine examinations,collected four blood coagulation indexes,obtained IIEF-5 scores and sexual hormone levels,and recorded the nocturnal penile tumescence（ NPT） and results of polysomnographic sleep monitoring of the patients. After 1,4,8,12,and 24 weeks of individualized treatment for each patient,we performed telephone follow-up for therapeutic effects and adverse drug reactions. Results： All the 9 patients were diagnosed with primary SRPE after excluding other diseases,6 of them treated with chlorimipramine or chlorimipramine combined with other medicine and the other 3 by antiandrogen therapy. Complete pain remission was achieved by 77. 78% at 4 weeks and 66. 67% at 24 weeks. The 3 patients treated by antiandrogen therapy experienced recurrence at 24 weeks but relieved after 1 week of adjusted treatment. Conclusion： Chlorimipramine,combination of chlorimipramine with medicine,and antiandrogen therapy are all evidently effective for the treatment of primary SRPE.