PDE-5抑制剂联合听视觉性刺激Rigiscan检测与夜间勃起功能检测在ED评估中的对比研究

PDE-5i combined with RigiScan-based audiovisual sexual stimulation test versus nocturnal penile tumescence test in evaluation of erectile function

目的:对比研究磷酸二酯酶5抑制剂(PDE-5i)联合听视觉性刺激(AVSS)RigiScan检测与阴茎夜间勃起功能检测(NPT),探讨PDE-5i联合AVSS检测在ED评估中的临床价值。方法:2017~2018年诊断为勃起功能障碍(ED)的166例患者,年龄21~63岁,中位年龄31岁;病程3个月至10年,平均14月;所有患者均完成NPT检测和PDE-5i联合AVSS检测,对比其检测结果。NPT正常的患者认为是心理性ED,异常的患者认为是器质性ED。结果:对比NPT检查,万艾可联合AVSS检测准确率与希爱力联合AVSS检测准确率无统计学差异(78.1%vs 79.7%,P>0.05)。PDE-5i联合AVSS检测在评估心理性ED中的敏感性达到78.9%,特异性达到90.7%,整体准确率达到81.9%。根据PDE-5i联合AVSS检测结果将患者分为勃起正常组及异常组,两组在年龄、病程、IIEF-5评分及阴茎头部硬度≥60%的维持时间方面存在统计学差异(P<0.05)。受试者工作特征(ROC)曲线说明PDE-5i联合AVSS检测能够准确的反映患者勃起功能的情况。结论:药物联合AVSS检测简单、经济、有效,具有较好的敏感性与特异性,可作为ED患者病因评估的首选筛查方法。

Objective:To explore the clinical value of phosphodiesterase type-5 inhibitors(PDE-5 i)combined with RigiScan-based audiovisual sexual stimulation(AVSS)test in comparison with that of nocturnal penile tumescence(NPT)test in evaluation of erectile function.Methods:A total of 166 ED patients,aged 21-63(mean 31)years,with a disease course of 3 months to 10 years(mean 14 months),underwent NPT test or PDE-5 i+RigiScan-based AVSS test from 2017 to 2018.We compared the results of the diagnostic strategies.Normal NPT patterns were presumed to indicate psychogenic and abnormal ones to indicate organic ED.Results:Compared with the results of NPT test,no statistically significant difference was observed in the accuracy rate between Viagra+AVSS test and Cialis+AVSS test(P>0.05).PDE-5 i+RigiScan-based AVSS test achieved a sensitivity of 78.9%and a specificity of 90.7%in the diagnosis of psychogenic ED and an overall accuracy rate of 81.9%.According to the results of PDE-5 i+RigiScan-based AVSS test,the patients fell into a normal and an abnormal erection group,with significant differences between the two groups in age,disease course,IIEF-5 score and maintenance time of penile tip rigidity≥60%(P<0.05).ROC curve analysis indicated that PDE-5 i+RigiScan-based AVSS test accurately manifested the erectile function of the patients.Conclusion:Compared with NPT test,PDE-5 i combined with RigiScan-based AVSS test is simple,inexpensive,practical and with a high sensitivity and specificity,and therefore can be used as the first-choice strategy for etiological diagnosis of ED.