阻塞性睡眠呼吸暂停对男性患者性功能影响的临床研究

Obstructive sleep apnea affects the sexual function of the male patient

目的:探讨男性阻塞性睡眠呼吸暂停(OSA)患者性功能改变的研究方法及影响因素。方法:对81例男性OSA患者,年龄(40.5±8.6)岁与35例健康志愿者,年龄(38.8±10)岁,采用亚利桑那性体验量表(ASEX)与Epworth嗜睡量表(ESS)问卷调查。以ASEX性驱动力项目评分4分归为性驱动力下降组[n=32,年龄(41.97±8.88)岁],评分<4归为非性驱动力下降组[n=49,年龄(39.49±8.29)岁],比较患者一般特征与PSG数据。将性驱动力评分与PSG数据做多元线性回归,评价影响性冲动能力因素。结果:OSA组患者ESS评分[(8±5)vs(5±4),P<0.05)]、ASEX评分[(10±2)vs(15±4),P<0.05)]均显著高于对照组;OSA患者中性驱动力下降组ESS评分[(9±5)vs(6±5),P<0.05)]、血氧饱和度低于90%时间(SIT90)[(41.01±26.95)vs(21.87±19.03),P<0.05)]显著高于非性驱动力下降组。多元回归分析显示年龄(β=0.25,P<0.001)、SIT90(β=0.4,P<0.001)影响OSA患者性冲动力评分。结论:OSA影响男性性功能的各个方面,其中以性驱动力下降最突出;夜间缺氧时间及年龄是OSA患者性驱动力下降的独立危险因素;性驱动力下降可视为OSA的一种主要临床症状。

Objective： To explore the factors influencing the sexual function of the male patients with obstructive sleep apnea（ OSA）. Methods： Using Arizona Sexual Experience Scale（ ASEX） and Epworth Sleepiness Scale（ ESS）,we conducted a questionnaire investigation among 81 male patients with OSA aged 40. 5 ± 8. 6 years and 35 healthy volunteers aged 38. 8 ± 10 years. According to the sex drive（ SD） score in ASEX,we divided the OSA patients into an SD reduction group（ SD score = 4,n = 32） and a non-SD reduction group（ SD score 4,n = 49）,compared the clinical data and polysomnographic（ PSG） indexes,and analyzed the factors influencing SD by evaluating the association of the PSG indexes with the SD score. Results： The OSA patients scored significantly higher than the healthy controls in ESS（ 8 ± 5 vs 5 ± 4,P 〈0. 05） and ASEX（ 15 ± 4 vs 10 ± 2,P 〈0. 05）,and so did the patients of the SD reduction group than those of the non-SD reduction group in ESS（ 9 ± 5 vs 6 ± 5,P 〈0. 05） and saturation impair time below 90%（ SIT90）（ 41. 01 ± 26. 95 vs 21. 87 ± 19. 03,P 〈0. 05）. Multivariate regression analysis revealed that the SD score was significantly correlated with age（ β = 0. 25,P 〈0. 001） and SIT90（ β = 0. 4,P 〈0. 001） in the OSA patients.Conclusion： OSA affects various aspects of the sexual function,particularly SD,of the patient. The duration of hypoxia and age of the patient are independent risk factors for SD reduction,which can be considered as a main clinical symptom of OSA.