早泄诊治中自评估IELT替代秒表记录IELT应用的可行性Meta分析

Meta-analysis of the feasibility of substituting stopwatch-measured IELT with estimated IELT in the evaluation of premature ejaculation

目的:评价早泄(PE)诊治中自评估阴道内射精潜伏时间(eIELT)替代秒表测量阴道内射精潜伏时间(sIELT)应用的可行性,为PE诊治中评价指标的选择提供科学依据。方法:检索PubMed、Embase、Cochrane Library、CNKI数据库、万方资源数据库、SinoMed中有关eIELT与sIELT的对照性研究,并进行Meta分析。主要评价eIELT和sIELT 2项指标。结果:检索出相关文献894篇,剔除889篇,共有5篇文献符合纳入标准。Meta分析结果显示:男性人群总体各研究间结果存在明显异质性(P<0.000 01,I^2=87%),eIELT与sIELT间差异有统计学意义(SMD=0.18,95%CI:0.01~0.36,P=0.04);PE组各研究间存在异质性(P<0.000 01,I^2=86%),eIELT与sIELT间差异无统计学意义(SMD=0.09,95%CI:-0.22~0.40,P=0.57);非PE组各研究间存在异质性(P=0.03,I^2=79%),eIELT与sIELT间差异有统计学意义(MD=2.90,95%CI:1.78~4.03,P<0.000 01)。结论:本研究表明在PE患者的诊断和疗效评估中,eIELT可替代sIELT使用,而针对正常男性性生活时间的评价中,eIELT较sIELT有过高的趋势,不推荐直接替代应用。

Objective：To evaluate the feasibility of substituting stopwatch-measured IELT with estimated IELT in the evaluation of premature ejaculation and to provide scientific evidence for the selection of evaluation tools for the diagnosis and treatment of PE.Method：The PubMed,Embase,Cochrane Library,CNKI Database,Wanfang Database and SinoMed were searched for literature on estimated IELT and stopwatch-measured IELT.Meta-analysis was performed on the identified publications.Result：A total of 894 pieces of related literature was retrieved and 5 pieces of literature met the inclusion criteria.The meta-analysis results showed that there was significant heterogeneity（P〈0.000 01,I^2=87%）and there was significant difference between the two types of IELT（SMD=0.18,95%CI：0.01-0.36,P=0.04）among the studies of the total males.There was heterogeneity（P〈0.000 01,I^2=86%）but there was no difference between the two types of IELT（SMD=0.09,95%CI：-0.22-0.40,P=0.57）among the studies of the PE group.There was heterogeneity（P=0.03,I^2=79%）and there was significant difference between the two types of IELT（MD=2.90,95%CI：1.78-4.03,P〈0.000 01）among the studies of the non-PE group.Conclusion：This study indicates that stopwatch-measured IELT can be substituted by estimated IELT as an evaluation tool for the diagnosis and treatment of PE.But for the normal males,the estimated IELT can be longer than stopwatch-measured IELT.Therefore direct replacement is not recommended.