良性前列腺增生患者性功能变化及其危险因素分析

Analysis of sexual function changes and risk factors in patients with benign prostatic hyperplasia

目的研究良性前列腺增生(BPH)患者性功能变化并分析其危险因素。方法选取2017年1月至2019年7月广东省东莞市人民医院收治的200例BPH患者作为研究对象。按照国际前列腺症状评分(IPSS)的不同,将所有BPH患者分成轻度组(n=60)、中度组(n=73)以及重度组(n=67),比较三组的勃起功能国际问卷5(IIEF-5)评分、性欲以及射精功能评分等情况,并进行Pearson相关性分析。按照IIEF-5评分的不同分成BPH伴无或轻度ED组(n=103,IIEF-5评分≥12分)、BPH伴中或重度ED组(n=97,IIEF-5评分≤11分),比较两组基线资料[主要包括年龄、吸烟史、饮酒史、IPSS、血清前列腺特异抗原(PSA)、最大尿流率以及前列腺体积等],并进行多因素Logistic回归分析。结果中度组和重度组的IIEF-5、性欲以及射精功能评分均低于轻度组,且重度组低于中度组,差异具有统计学意义(P<0.05)。经Pearson相关性分析显示,BPH患者病情严重程度与IIEF-5、性欲、射精功能评分均呈负相关(P<0.05)。BPH伴中或重度ED组年龄≥65岁人数占比、前列腺体积均显著高于BPH伴无或轻度ED组,而最大尿流率显著低于BPH伴无或轻度ED组,差异具有统计学意义(P<0.05);两组年龄、吸烟史、饮酒史、IPSS、血清PSA水平比较,差异无统计学意义(P>0.05)。经多因素Logistic回归分析,年龄≥65岁、前列腺体积增大以及最大尿流率降低均为BPH伴中或重度ED的独立危险因素(P<0.05)。结论 BPH患者普遍存在不同程度的性功能障碍,应予以重视,且年龄的增长,前列腺体积的增大,最大尿流率的降低,均会增加BPH患者性功能障碍的发生风险。

Objective To study sexual function changes in patients with benign prostatic hyperplasia(BPH)and analyze their risk factors.Methods 200 patients with BPH admitted to Dongguan People's Hospital from January 2017 to July 2019 were selected,and divided into mild group(n=60),moderate group(n=73)and severe group(n=67)according to the international prostate symptomatic score(IPSS).The IIEF-5,libido and e-jaculation scores in the three groups were compared,and Pearson correlation analysis was performed.According to IIEF-5 score,the patients were divided into BPH with no or mild ED group(n=103,IIEF-5 score≥12 points)and BPH with moderate or severe ED group(n=97,IIEF-5 score≤11 points).Baseline data[including age,smoking history,history of drinking,IPSS,serum prostate specific antigen(PSA),maximum urinary flow rate and volume of the prostate,etc]were compared between the two groups,and multivariate Logistic regression analysis was performed.Results The scores of IIEF-5,libido and ejaculation scores in moderate and severe groups were lower than those in mild group,and those in severe group were lower than those in moderate group,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the severity of BPH patients was negatively correlated with IIEF-5,libido and ejaculation score(P<0.05).The proportion of people aged≥65 years and prostate volume in BPH group with moderate or severe ED were significantly higher than those in BPH group with no or mild ED,while the maximum urinary flow rate was significantly lower than that in BPH group with no or mild ED,the difference was statistically significant(P<0.05).There were no significant differences in age,smoking history,drinking history,IPSS and serum PSA levels between the two groups(P>0.05).According to multivariate Logistic regression analysis,age≥65 years,enlarged prostate volume and decreased maximum urinary flow rate were independent risk factors for BPH with moderate or severe ED(P<0.05).Conclusions BPH pa-tients generally have different degrees of sexual dysfunction,which should be paid attention to.The increase of age,the increase of prostate volume,and the decrease of the maximum urine flow rate,will increase the risk of sexual dysfunction in BPH patients.