甲状腺激素阴茎神经电生理诱发早泄的作用机制

Thyroid hormones induce premature ejaculation by influencing penile neuro-electrophysiology

目的甲状腺激素功能改变影响男性性功能的具体生理机制尚不明确。文中旨在探讨甲状腺激素通过影响阴茎神经电生理而诱发早泄的作用。方法回顾性分析2015年10月至2016年12月于南京总医院男科门诊就诊,并诊断为继发性早泄患者52例(早泄组),同期来院进行体检的24名健康男性作为对照组。所有被纳入者经过男科体检及甲状腺激素检验。此外,继发性早泄患者经过阴茎交感皮肤反应(PSSR)检查,根据PSSR潜伏期长短,将早泄组分为PSSR正常组及异常组。结果早泄组总四碘甲状腺原氨酸(TT4)水平显著高于对照组,差异有统计学意义[(92.68±11.56)nmol/L vs(102.81±18.37)nmol/L,P=0.018)];与PSSR正常组相比,异常组的TT4及游离四碘甲状腺原氨酸(FT4)水平均显著增高,分别为[(95.72±12.42)nmol/L vs(113.28±20.89)nmol/L,P<0.01]和[(10.81±1.63)nmol/L vs(12.02±0.88)nmol/L,P=0.003]。FT4与PSSR潜伏期呈负相关(r=-0.363,P=0.008),与PEDT呈正相关(r=0.455,P=0.001)。结论继发性早泄患者异常的PSSR可能与甲状腺激素的水平升高相关;调节伴有异常PSSR的继发性早泄患者的甲状腺激素水平有利于改善其早泄症状。

Objective The change of thyroid hormones affects male sexual function, but the underlying physiological mecha-nism is not yet clear. The aim of this study was to explore the association of thyroid hormones with abnormal penile neuro-electrophysiol-ogy in patients with premature ejaculation （PE）. Methods This retrospective study included 52 acquired PE （APE） patients aged 35.36 ± 8.39 years and 24 healthy males aged 32.87±7.45 years. We measured the levels of thyroid hormones in all the subjects and, based on the latency time of penile sympathetic skin responses （PSSR） , classified the APE patients into a normal （n=31） and an ab-normal PSSR type （n=31）. Results The concentration of total tetraiodothyronine （ TT4） in the serum was significantly higher in the APE patients than in the normal control （ [ 102.81 ± 18.37] vs [ 92.68±11.56] nmol/L, P = 0.018） . The levels of serum TT4 and free tetraiodothyronine （FT4） were both markedly increased in the APE patients of the abnormal PSSR type as compared with those of the normal PSSR type （ [ 113.28±20.89]vs [ 95.72± 12.42] nmol/L, P〈0.001 and [12.02±0.88] vs[10.81±1.63] nmol/L, P = 0.003） . The FT4 concentration was correlated negatively with the latency time of PSSR -0 .3 6 3 , P = 0.008） and positively with the Premature Ejaculation Diagnostic Tool （ PEDT） scores （ r = 0 .4 5 5, P = 0 .001 ） . Conclusion Abnormal PSSR may be associated with elevated levels of thyroid hormones in APE patients, and regulation of thyroid hormone levels may help improve the symptoms of PE with ab-normal PSSR.