视听性刺激勃起检测(AVSS)对勃起功能障碍诊断价值的临床研究

The diagnostic value of audiovisual sexual stimulation(AVSS) on erectile dysfunction

目的探索视听性刺激勃起检测(AVSS)对勃起功能障碍的临床诊断价值。方法选择2012年至2016年本院男科AVSS检测数据库,汇总分析包括常规的人口学资料、Rigiscan Plus数据以及阴茎多普勒超声血流参数。根据国际勃起功能指数问卷表(IIEF-5)评分和阴茎海绵体血管参数对受试者进行勃起功能障碍(ED)分组,评估AVSS检测的有效勃起硬度及维持时间对ED和血管性ED的诊断价值。结果共396例符合条件的受试者纳入分析,平均年龄为(32.3±7.2)岁。根据IIEF-5评分的分组结果,ED组共373例,无ED组23例。AVSS检测反应阳性者阴茎头端硬度≥60%、维持时间为9.25min(灵敏度73.3%,特异度73.5%)和阴茎根部硬度≥60%、维持时间为19.75min(灵敏度66.7%,特异度69.8%)的排除ED诊断的效价最高。根据彩色多普勒超声(CDDU)参数的分组结果,血管性ED组97例,非血管性ED组299例,两组间AVSS检测勃起硬度的维持时间差异无统计学意义(P<0.05)。结论AVSS检测是一种快捷、实用及客观的门诊筛查ED方法。勃起反应阳性者阴茎头端硬度≥60%的时间大于9min或阴茎根部硬度≥60%的时间大于19min时排除ED的效价最高。

Objective To explore the clinical value of audiovisual sexual stimulation（AVSS） test in the diagnosis of erectile dysfunction. Methods All the cases were derived from AVSS test database in our andrologic center from 2012 to 2016. Clinical data of the patients including demographic data, Rigiscan Plus data and cavernous artery Color Doppler duplex ultrasound（CDDU） parameters were comparatively analyzed. The patients in erectile dysfunction（ED） group was confirmed according to the International Index of Erectile Function-5（IIEF-5） scores and the vasculogenic ED was diagnosed by corpus cavernosum parameters. The diagnostic value of effective erection rigidity and duration of AVSS test were evaluated by analyzing ED and non-ED group. Results A total of 396 eligible subjects were included in the analysis, with an average age of 32.3±7.2 years. According to the diagnostic criteria of IIEF-5 score, there were 373 ED patients and 23 cases without ED. The tip rigidity ≥60% with duration 9.25 min（sensitivity： 73.3%; specificity： 73.5%） or base rigidity ≥60% with duration 19.75 min（sensitivity： 66.7%; specificity： 69.8%） showed the highest diagnostic value. There were 97 cases of vasculogenic ED and 299 cases of non-vasculogenic ED. No significant differences were found in term of AVSS test parameters between the two groups. Conclusion AVSS is a rapid, practical and objective method for screening ED. The tip rigidity ≥60% with duration more than 9 min or base rigidity ≥60% with duration more than 19 min presented highest diagnostic value for ED.