PDE-5i联合AVSS RigiScan检测对ED患者特征及PCDU综合评估的分析

Characteristics of patients with erectile dysfunction(ED)and abnormalities of PDE-5i combined with RigiScan-based AVSS test detected by using penile color Doppler ultrasonography(PCDU):a comprehensive review

目的采用阴茎血流彩色多普勒超声(PCDU)对磷酸二酯酶5抑制剂(PDE-5i)联合听视觉性刺激(AVSS)阴茎硬度测量仪(RigiScan)检测异常的阴茎勃起功能障碍(ED)患者特征进行综合评估,探讨PCDU在ED评估中的临床价值。方法选择2014年1月至2021年10月就诊于中国中医科学院西苑医院男科诊断为ED且行PDE-5i联合AVSS的RigiScan检测结果为异常的患者共1477例,平均年龄(36.16±9.39)岁,平均病程(33±9.12)月,所有患者均完成PCDU检查。结果根据PCDU诊断标准将受检者分为四组:非血管性ED组611例(41%)、动脉性ED组266例(18%)、静脉性ED组375例(26%)和动静脉混合性ED组225例(15%),对四组患者一般特征及各项PCDU指标进行多组间比较。其中,除各组间病程无统计学差异外,各组间年龄、右侧阴茎海绵体动脉收缩期峰值流速(PSV)、右侧舒张末期流速(EDV)、右侧阻力指数(RI)、左侧PSV、左侧EDV、左侧RI比较均有统计学差异(P<0.05)。结论药物联合AVSS的RigiScan检测虽具有简便、可重复性等特点,但不能很好地区分非血管性ED和血管性ED,临床上仍需结合PCDU检查对血管性ED进一步诊断。年龄是血管性ED病情趋于加重的独立风险因素。

Objective To comprehensively review the characteristics of patients with erectile dysfunction(ED)and abnormalities of PDE-5i combined with test of RigiScan-based audiovisual sexual stimulation(AVSS)detected by using penile color Doppler ultrasonography(PCDU),and discuss the clinical value of PCDU in ED reviewing.Methods ED patients(n=1477,average age=36.16±9.39,average ED course=33±9.12 months),with abnormalities of PDE-5i combined with test of RigiScan-based AVSS,were chosen from Department of Andrology in Xiyuan Hospital of China Academy of Chinese Medical Sciences from Jan.2014 to Oct.2021.All patients received PCDU examination.Results According to PCDU diagnostic criteria,all patients were divided into 4 groups:non-vasogenic ED group(n=611,41%),arteriogenic ED group(n=266,18%),venous ED group(n=375,26%)and arteriovenous ED group(n=225,15%).The general characteristics and all indexes of PCDU were compared among 4 groups.Except of disease course without statistical difference,the differences in age and right peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI)and left PSV,EDV and RI of corpus cavemosum all had statistical significance(P<0.05)among 4 groups.Conclusion Although RigiScan-based AVSS test combined medicinal is simple and reproducible,it cannot distinguish non-vasogenic ED from vasogenic ED,and further diagnosis of vasogenic ED still needs to be combined with PCDU test in clinical practice.Age is an independent risk factor for exacerbation of vasogenic ED.