基于logistic模型的血铅异常与性功能障碍的多因素分析

Multivariate analysis of the effects of abnormal blood lead on sexual dysfunction based on logistic model

目的探讨血铅异常对性功能的改变及其影响因素。方法以2015-2018年间绍兴地区接受驱铅治疗的血铅异常者为研究对象,采用石墨炉原子吸收光谱法测定患者血铅浓度,提取并完善患者电子病历信息。将记录有性欲减退、男性勃起功能障碍、早泄等症状的患者列为性功能障碍病例,将性功能未改变的患者列为对照组病例进行对照研究,采用单因素和多因素分析,运用R语言对比分析两组病例的血铅水平、临床症状、人口学特征的差异,归纳血铅异常对性功能变化的主要影响因素。结果性功能障碍病例共12例,对照组病例共119例。性功能障碍病例的血铅浓度、年龄、铅暴露时长分别为(746±52.3)μg/L、(30.6±4.62)岁、(28.5±21.6)个月,明显高于对照组的(601±120)μg/L、(47.3±9.79)岁、(96.9±72.3)个月,差异有统计学意义(t=1.571、2.180、1.283,P<0.01),性功能障碍病例的女性占比为25%,高于对照组的16.8%,差异有统计学意义(OR=0.04,P<0.05)。应用多因素logistic回归模型分析发现,性功能障碍病例的血铅浓度高于对照组,差异有统计学意义(OR=1.02,P<0.01),性功能障碍病例的女性占比高于对照组,差异有统计学意义(OR=0.04,P<0.05)。结论血铅浓度达到较高水平时可能罹患性功能障碍风险高。

Objective To explore the changes and effects of abnormal blood lead on sexual function.Methods The subjects of the study were patients with abnormal blood lead who received lead-removal treatment in Shaoxing from 2015 to 2018.Graphite furnace atomic absorption spectrometry was used to determine the blood lead concentration of patients,and to extract and improve the patient’s electronic medical record information.Patients who recorded symptoms of decreased libido,male erectile dysfunction,and premature ejaculation were classified as cases of sexual dysfunction,and patients with unchanged sexual function were listed as control cases for a control study.Single-factor and multi-factor analysis,and R Programming Language was used to compare the differences in blood lead levels,clinical symptoms,and demographic characteristics between two groups of cases.The main influencing factors of abnormal blood lead on changes in sexual function are summarized.Results There were 12 cases with sexual dysfunction and 119 cases with non-sexual dysfunction.The blood lead concentration,age,and lead exposure duration of the sexual dysfunction cases were(746±52.3)μg/L,(30.6±4.62)years,and(28.5±21.6)months,which were significantly higher than those in the control group(601±120)μg/L,(47.3±9.79)years old,and(96.9±72.3)months,and the differences were statistically significant(t=1.571、2.180、1.283,P<0.01).The proportion of women in sexual dysfunction cases(25%)was higher than that in the control group(16.8%),with a statistically difference(OR=0.04,P<0.05).Through multivariate logistic regression model analysis,we found that the proportion of women in sexual dysfunction cases was higher than that in the control group,with a statistically difference(OR=0.04,P<0.05),and the blood lead concentration was higher than that of the control group,the difference was statistically significant(OR=1.02,P<0.01).Conclusion People with high blood lead levels may be at high risk for sexual dysfunction.