男性ESRD患者肾移植手术前后焦虑、抑郁和性功能的变化及其相关性研究

Changes of anxiety,depression and sexual function in male patients with ESRD before and after kidney transplantation and their correlation

目的研究男性ESRD患者肾移植手术前后的焦虑、抑郁和性功能变化,并探讨其相关性。方法以2017年1月至2020年6月间于我院诊断为终末期肾脏病(ESRD)并成功行同种异体肾移植手术的60例男性患者作为研究对象,了解患者的一般人口学信息,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组人员的焦虑和抑郁情况,采用勃起功能评分量表(IIEF-5)和早泄诊断工具量表(PEDT)评估其勃起和射精功能,分析ESRD患者在肾移植术前、术后的焦虑、抑郁情况和勃起、射精功能变化,并探讨焦虑、抑郁分别与勃起功能、射精功能的相关性。结果ESRD患者肾移植术前焦虑、抑郁发生率较术后更为普遍(焦虑:75%&41.67%;抑郁:36.67%&13.33%;SAS评分:57.25±10.87&49.20±11.69;SDS评分:42.83±14.90&34.77±12.61;P<0.01);肾移植术前勃起功能障碍和早泄的发生率明显高于肾移植术后(ED:61.67%&43.33%;疑似和确诊PE:41.67%&18.33%;IIEF-5评分:15.35±6.99&19.57±5.95;PEDT评分:9.00±3.41&6.95±2.17;P<0.01)。进一步行相关性分析,肾移植术前:IIEF-5评分与SAS评分(r=-0.922;P<0.01)、与SDS评分(r=-0.707;P<0.01)呈负相关,PEDT评分与SAS评分(r=0.838,P<0.01)、与SDS评分(r=0.708,P<0.01)呈正相关;肾移植术后,患者的焦虑、抑郁和性功能障碍问题均改善:IIEF-5评分与SAS评分(r=-0.701;P<0.01)、与SDS评分(r=-0.559;P<0.01)呈负相关,PEDT评分与SAS评分(r=0.778,P<0.01)、与SDS评分(r=0.692,P<0.01)呈正相关。结论ESRD患者在肾移植术前透析治疗期间焦虑、抑郁的发生率高,性功能障碍常合并出现,且焦虑、抑郁评分和性功能结果之间具有相关性;肾移植术后患者的心理状态和性功能问题有所改善,但二者仍继续存在并保持相关性。

Objective To explore the changes of anxiety,depression and sexual function in male patients with end-stage renal disease(ESRD)before and after kidney transplantation(KT)and their correlation.Methods A total of 60 male patients with ESRD who underwent KT in our hospital from January 2017 to June 2020 were enrolled in this study.The general demographic information of the patients was analyzed.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to assess the anxiety and depression of the patients.The erectile function rating scale(IIEF-5)and the premature ejaculation(PE)diagnostic tool scale(PEDT)were applied to evaluate their sexual function.Changes of anxiety and depression before and after KT and the changes of erection and ejaculatory function were comparatively analyzed,and their correlations were explored.Results Preoperative anxiety and depressionin patients with ESRD were more common than those after KT.The incidence of erectile dysfunction(ED)and PE before KT were higher than that after KT.Before KT,IIEF-5 score was negatively correlated with SAS score(r=-0.922,P<0.01)and SDS score(r=-0.707,P<0.01),PEDT score was positively correlated with SAS score(r=0.838,P<0.001)and SDS score(r=0.708,P<0.01).After KT,anxiety,depression and sexual dysfunction problems were all improved.IIEF-5 was negatively correlated with SAS(r=-0.701,P<0.01)and SDS(r=-0.559,P<0.01),while PEDT was positively correlated with SAS(r=0.778,P<0.01)and SDS(r=0.692,P<0.01).Conclusion The incidence of anxiety and depression in patients with ESRD is high before KT,and their sexual dysfunction often co-occurs.There exists a linkage between psychological state and sexual function.Psychological status and sexual function of the patients after KT have improved,but they still exist and remain correlated.