阻塞性睡眠呼吸暂停低通气综合征与勃起功能障碍的相关性研究

Correlation between obstructive sleep apnea-hypopnea syndrome and erectile dysfunction

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者与勃起功能障碍(ED)之间的相关性。方法:OSAHS患者60例,纳入观察组;门诊体检健康志愿者60例,纳入对照组,采用PSG睡眠监测仪和NPT同步监测两组患者睡眠状态及阴茎勃起情况,包括呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(min Sa O2)和阴茎血容积变化率(%)。硝酸还原酶法、比色法分别检测NO、i NOS浓度,ECLIA法检测血清睾酮(T)、游离睾酮(FT)、卵泡刺激素(FSH)、黄体生成激素(LH)、催乳素(PRL)水平,国际勃起功能指数评分5项(IIEF-5)评估男性OSAHS患者ED的发病率,并对数据进行相关分析。结果:OSAHS组T(2.10±2.42)、FT(9.76±2.33)、NO(72.51±11.74)、iN OS(25.32±11.57)、minS aO 2(71.23±5.71)、阴茎血容积变化率(158.36±32.87),与对照组相比,差异有非常显著的统计学意义(P<0.01),OSAHS组AHI(45.75±11.92)显著高于对照组(P<0.05)。OSAHS患者ED的发生率显著高于对照组(P<0.01),重度ED患者NO(32.57±6.33)、iN OS(8.06±1.01)、阴茎血容积变化率(135.56±16.92)及IIEF-5总分(5.3±2.3)明显低于轻中度ED患者(P<0.01)。结论:OSAHS与ED有明显的相关性,NO升高、低氧血症、T降低可能是OSAHS患者导致ED的机制。

Objectives： To investigate the correlation of obstructive sleep apnea- hypopnea syndrome（ OSAHS） with erectile dysfunction. Methods： 60 OSAHS patients were selected as observation group and 60 healthy subjects as controls group. The dormancy and penile erection of two groups were determined synchronously by polysomnography and nocturnal penile tumeascence,including appnea hypopnea index（ AHI）,minimal arterial blood oxygen saturation（ min Sa O2） and change rate of penis＇ blood volume（ %）. NO was measured by nitrate reduction enzymatic method,and i NOS by colorimetric assay,testosterone,T,FT,FSH,LH,PRL by electrochemiluminescence immunoassay（ ECLIA）,and the incidence of erectile dysfunction among OSAHS patients was evaluated by 5- item version of the international index of erectile function（ IIEF- 5）. Results： For OSAHS group,the results included testosterone（ 2. 10 ± 2. 42）,flow testosterone（ 9. 76 ± 2. 33）,nitric oxide（ 72. 51 ± 11. 74）,inducible nitric oxide synthase（ 25. 32 ± 11. 57）,minimal arterial blood oxygen saturation（ 71. 23 ± 5. 71） and change rate of penis＇ blood volume（ 158. 36 ± 32. 87）,with significant difference from the control group（ P〈0. 01）; the appnea hypopnea index of OSAHS group was significantly higher than that in control group（ P〈0. 05）. The incidence rate of OSAHS with erectile dysfunction was higher than the control group（ P〈0. 01）,NO（ 32. 57 ± 6. 33）,i NOS（ 8. 06 ± 1. 01）,change rate of penis＇ blood volume（ 135. 56 ± 16. 92） and IIEF- 5（ 5. 3 ± 2. 3） in patients with severe erectile dysfunction were significantly less than those in patients with slight and midrange erectile dysfunction（ P〈0. 01）. Conclusions： There is apparent correlation between OSAHS and erectile dysfunction,and the increase in NO,hypoxemia and decrease of testosterone may be the mechanism of OSAHS patient with erectile dysfunction.