Prevalence and risk factors of erectile dysfunction in three cities of China: a community-based study

Aim: To determine the age-adjusted prevalence of erectile dysfunction (ED) in 3 big cities of China and to explore its potential sociodemographic, medical and lifestyle correlates. Methods: A cross-sectional, population-based survey was conducted in three cities of China. Structured questionnaires were administered to 2 226 men, aged 20 - 86 years, by trained interviewers. Results: The age-adjusted prevalence of ED was 28.34 % (mild 15.99 %, moderate 7.14 %, severe 5.21 %). In the men above 40, the prevalence was 40.2%. Age was positively correlated with ED (P<0.01). Education was negatively correlated with ED (P<0.01). Spouse companionship, living condition were positively correlated with ED (P<0.01). Histories of cardiovascular disease, diabetes, and hyperlipidemia were positively correlated with ED (P<0.01). Cigarette smoking was not correlated with ED (P>0.05), while the cigarette consumption and duration were positively correlated with ED (P<0.01). Alcohol drinking is negatively correlated with ED (P<0.01). The duration of drinking was positively correlated with ED (P<0.01). Weekly alcohol consumption was not correlated with ED (P>0.05). Conclusion: The prevalence of ED increased with age. Cardiovascular disease, diabetes and hyperlipidemia were positively correlated with the increased prevalence. Sociodemographic and lifestyle factors, such as education, spouse companionship, living condition, cigarette and alcohol consumption or duration also have association with the prevalence of ED.

Tadalafil treatment had a modest effect on endothelial cell damage and repair ability markers in men with erectile dysfunction and vascular risk

The number of the circulating angiogenic cells （CACs） and colony forming units （CFUs） derived from cultured circulating mononuclear cells （MNCs） represents a laboratory surrogate for endothelial cell repair ability. The serum of men with erectile dysfunction （ED） and vascular risk factors （VRFs） showed an increased level of endothelial cell damage/dysfunction markers and reduced the numbers of CACs and CFUs derived from the cells of healthy men. We analyzed whether treating men with ED and VRFs with the selective phosphodiesterase type 5 inhibitor tadalafil improved the endothelial cell repair ability and reduced the levels of the serum markers of endothelial cell damage/dysfunction. MNCs from healthy men were cultured with 20% serum from 36 ED patients to obtain CACs and CFUs. The ED patients were evaluated before and after 4weeks of treatment with tadalafil （20 mg every other day） or with a placebo. The tadalafil treatment improved erectile function （P = 0.0028）, but had no effect on the inhibitory effects of serum from ED patients on the CACs and CFUs derived from healthy men. The levels of endothelin-1 （P = 0.011） and tissue type plasminogen activator （P = 0.005） were reduced after treatment compared to baseline and those of the placebo group, whereas no changes were observed in the E-selectin levels. The tadalafil treatment in the ED patients with VRFs resulted in only a modest effect on the laboratory measures of the endothelial cell damage/dysfunction and repair ability. The proposed beneficial effect of phosphodiesterase type 5 inhibition on vascular homeostasis requires further analysis.

A Cross-Sectional Study According to Risk Factors Associated with Erectile Dysfunction in Men

Background: Erectile dysfunction (ED) is a common condition in general population. It has a negative impact on the couple’s quality of life. In 1995, it was estimated that it affected 152 million people worldwide, and that it would affect more than 322 million people in 2025 with a large increase in developing countries. Several studies have suggested a causal link between ED and cardiovascular disease. In the Democratic Republic of Congo, no studies exist on this subject. Nonetheless, we are seeing increased promotion on the management of sexual disorders in our media, which could testify to the extent of this problem. Objective: To assess the extent of cardiovascular risk factors for ED in Kinshasa. Material and Methods: This is a cross-sectional study for analytical purposes. It collected several categories of individuals from May 1 to October 31, 2018. The severity of ED was assessed by the IIEF-5 score and the associated risk factors sought via logistic regression. Results: The mean age of the respondents was 59.9 ± 19.2 years, more than half of the respondents were over the age of 60 years old (60%). The ED proportion was 78.8%, and 75% of respondents had at least moderate ED. This anomaly was significantly elevated among respondents aged over 60 years (94.8%), diabetics (87.5%), hypertensive patients (92.3%) and stroke victims (86%). The independently associated risk factors were: age > 60 years [ORa: 9.87;95% CI: 6.42 - 10.48, p < 0.001], diabetes mellitus [ORa: 2.99;95% CI: 1.80 - 4.95, p = 0.013] and the stroke [ORa: 2.1;95% CI: 1.36 - 3.39;p = 0.012%]. The age threshold predicting ED was 67 years. Conclusion: ED is a frequent disorder in our environment and likely to affect the quality of life of men who suffer from it. There is an ED and cardiovascular risk factors correlation. A proactive attitude of the caregiver in current practice would allow early detection of ED with a view to early and optimal management.

Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction （ED） in type 2 diabetes mellitus （T2DM） patients in the primary care setting, a multi-center cross-sectional survey using a structured anonymous self-administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects （91% response rate）, the prevalence of ED men, as defined by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED （28.9%）, followed by mild-to-moderate ED （27.9%）, then moderate ED （13.4%） and severe ED （9%）. Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor（s） should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment （41.7%）, followed by management of potential underlying cause （37.8%）, referral to specialist （27.5%）, education （23.9%）, prescription of phosphodiesterase type 5 inhibitors （16.9%） and referral to ~：ounseling service （6.7%）. The prevalence of ED was strongly associated with subjects who thought they had ED （odds ratio （OR） = 90.49 （20.00-409.48, P 〈 0.001）） and were from the older age group （OR = 1.043 （1.011-1.076, P = 0.008））. In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

Management of erectile dysfunction in hypertension:Tips and tricks

Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice.

Erectile dysfunction in hemodialysis: A systematic review

Men with chronic renal failure （CRF） on hemodialysis have been frequently associated with erectile dysfunc-tion （ED）, with an of between 20% to 87.7%. As a result of the multi-system disease processes present in many uremic men, it is apparent that the pathogenesis of ED is most probably multifactorial. Factors to be con-sidered include peripheral vascular disease, neurogenic abnormalities, hormonal disturbances and medications used for treatment of conditions associated with CRF. These physiological abnormalities may be supplement-ed by signifcant psychological stresses and abnormali-ties resulting from chronic illness. Treatment must start with the determination and treatment of the underlying causes. In addition to psychological treatment, furtherlines of treatment of ED in CRF can be classifed as 1stline （medical treatment which includes oral phosphodi-esterase-5 inhibitors and hormone regulation）, 2nd line（intracavernosal injection, vacuum constriction devicesand alprostadil urethral suppositories） or 3rd line （sur-gical treatment）. Renal transplantation improves thequality of life for some patients with CRF and subse-quently it may improve erectile function in a signifcantnumber of them, however still there is high incidenceof ED after transplantation.

Erectile Dysfunction: Clinical and Epidemiological Aspects in Senegal

Introduction: The objective of our study was to analyze the clinical and epidemiologic aspects of erectile dysfunction in subjects with different comorbidities in Senegal. Patients and Methods: This was a retrospective study over a period of 2 years on patients who presented themselves for consultation for erectile dysfunction. The study was carried out in the regions of Dakar and Thies at the Ouakam geriatric center and the Saint Jean of god Hospital of Thies respectively. Results: We enrolled into the study 402 patients with erectile dysfunction. The average age of our patients was 47 ± 5 years. Patients aged more than 60 years were the most. The majority of our patients had less than secondary school level education, 211 in total representing 52.5% of the study population compared to 14.9% having post baccalaureate level. A large number of these patients had professional activities (53.3%), followed by retirees (29.6%). Polygamous patients were more in number (51.5%). In our study sample, we registered 120 active smokers (29.9%). A hundred and ten of our patients were sedentary for periods of 5 months to 22 years. The average length of time before seeking help for erectile dysfunction in our patients was 2.8 years. Severe erectile dysfunction was predominant in the smoking group (54.2%) compared to (9.9%) in the non-smoking group. We found a large proportion of severe and moderate erectile dysfunction (66.3%) and (31.7%) respectively in diabetic than non-diabetic patients. Severe erectile dysfunction was more in hypertensive and diabetics. Severe erectile dysfunction was more present in hypertensive plus smokers (83.9%) than in non-smoking hypertensive patients (68.6%). Severe ED was found more in hypertension and diabetic subjects. Conclusion: Erectile dysfunction is most frequently related on one side to socio-environmental factors, and to co-existing comorbidities on the other side.

Correlates of Erectile Dysfunction in Nigerian Men with Type 2 Diabetes Mellitus: Experience from a Tertiary Health Center

Introduction: Erectile dysfunction (ED) is a common complication of diabetes mellitus (DM) that is associated with poor quality of life and can be present in type 2 diabetics at the time of diagnosis. There are common risk factors associated with erectile dysfunction in type 2 diabetic subjects. Some of these are potentially treatable or reversible. The risk factors evaluated by this study included glycaemic control, duration of diabetes, obesity, peripheral artery disease (PAD), hypertension and antihypertensive medications use. Materials and Methods: This study was a cross sectional one carried out over a period of six months (June-November, 2016) at the diabetes clinic of the Nnamdi Azikiwe University Teaching Hospital, Nnewi and involved 124 subjects with type 2 diabetes mellitus. A convenience sampling method was used. A detailed physical examination, blood pressure and anthropometric measurements and vascular assessment with a hand-held doppler ultrasound were carried out. Data was collected using a study proforma. Erectile dysfunction was diagnosed with the International Index of Erectile Function questionnaire while anxiety and depression were diagnosed with the Hospital Anxiety and Depression questionnaires. Subjects that had anxiety/depression or hypogonadism were excluded from the study. Results: A total of 124 subjects were studied, 48.4% of whom had erectile dysfunction. Glycaemic control was significantly associated with ED among the subjects (OR = 0.198, 95% CI = 0.081 - 0.483, P < 0.001). Similarly, peripheral artery disease (PAD) was significantly associated with ED in the subjects (OR = 2.867, 95% CI = 1.360 - 6.044, P = 0.006). However, no significant correlation was found between ED and obesity, duration of diabetes mellitus, antihypertensive medications use and duration of hypertension among the subjects (P > 0.05). Conclusion: Poor glycaemic control and presence of PAD significantly increase the risk of ED in male subjects with type 2 DM, thus underscoring the need for an early screening and treatment of these predictors of erectile dysfunction.

勃起功能障碍和下尿路症状在良性前列腺增生患者中的合并发生率及危险因素分析

目的:研究勃起功能障碍(ED)和下尿路症状(LUTS)在良性前列腺增生(BPH)人群中的合并发生率及危险因素分析。方法:2020年1月至2023年1月在中南大学湘雅二医院门诊就诊的BPH患者,根据纳入和排除标准确定纳入本研究的对象,收集一般资料和临床资料(包括年龄、身高、体重、腹围、臀围、血压、血常规、肝功能、肾功能、血脂和空腹血糖等),通过问卷调查进行国际前列腺症状评分(IPSS)、生活质量评分(QOL评分)和国际勃起功能指数(IIEF-5)评分。采用SPSS 22.0软件进行数据处理与分析。结果:ED合并LUTS在BPH患者各年龄组发生率分别为45~49岁组36.46%,50~54岁组43.72%,55~59岁组53.66%,60~64岁组69.23%,65~70岁组78.74%。LAP、VAI、TyG、HSI、BMI、WHtR、WHR、TG/HDL-C与IPSS得分呈正相关,与IIEF-5得分呈负相关;HDL-C/TC与IPSS得分呈负相关,与IIEF-5得分呈正相关。结论:ED合并LUTS在BPH患者中的发生率随年龄增加而增高,高血压、血脂异常、糖尿病、身高体重指数(BMI)、生活方式可能是ED合并LUTS发生的危险因素,LAP、VAI、TyG、HSI、BMI、WHtR、WHR、TG/HDL-C可有效评估ED合并LUTS在BPH患者中发生的风险。

阴茎海绵体注射试验对阴茎血管功能影响的回顾性研究

目的:探究勃起功能障碍(erectile dysfunction,ED)患者年龄、不同激素水平及生化指标对阴茎海绵体血管功能的影响。方法:回顾分析2020年1月至2023年8月于北京大学第三医院生殖医学中心男科进行彩色双频多普勒超声(color duplex Doppler ultrasonography,CDDU)联合阴茎海绵体注射试验(intracavernosal injection test,ICI)的ED患者的临床资料。使用SPSS 29.0建立数据库进行数据处理,采用多因素Logistic回归进行分析。结果:共纳入700例ED患者,其中ICI结果阴性380例,阳性320例;阴茎海绵体动脉收缩期速度(peak systolic velocity,PSV)<25 cm/s者84例,≥25 cm/s者616例;舒张末期速度(end diastolic velocity,EDV)>5 cm/s者202例,≤5 cm/s者498例;PSV和/或EDV结果异常者264例,PSV和EDV结果均正常者436例。血管性ED患者相较于非血管性ED患者雌二醇和睾酮水平更低(t=-3.546,P<0.001;t=-2.089,P=0.037),高血糖发生率更高(χ^(2)=12.772,P=0.002)。动脉性ED患者相较于非动脉性ED患者年龄更大(t=3.953,P<0.001),高血糖发生率更高(χ^(2)=9.518,P=0.009),雌二醇/睾酮比值更高(t=2.330,P=0.020)。动静脉混合性ED患者相较于均正常者的患者年龄更高(t=3.567,P<0.001),睾酮水平更低(t=-2.288,P=0.022),高血糖发生率更高(χ^(2)=12.877,P=0.002),雌二醇/睾酮比值更大(t=2.096,P=0.037)。多因素Logistic回归分析表明,雌二醇水平升高是血管性ED的保护因素(OR=1.009,95%CI:1.004~1.014),葡萄糖≥7.0 mmol/L是血管性ED的危险因素(OR=0.381,95%CI:0.219~0.661);年龄增长是动脉性ED的危险因素(OR=0.960,95%CI:0.938~0.982);年龄增长(OR=0.976,95%CI:0.958~0.993)、葡萄糖5.6~6.9 mmol/L(OR=0.591,95%CI:0.399~0.876)是动静脉混合性ED的危险因素。结论:高血糖和年龄增长可能使阴茎海绵体血管功能减退,而雌二醇水平升高可能对阴茎海绵体血管功能有保护作用。

良性前列腺增生术后阴茎勃起功能障碍发生风险的列线图模型建立与风险分层

目的探讨良性前列腺增生(BPH)患者术后阴茎勃起功能障碍(ED)发生的风险因素,并建立列线图模型及风险分层标准,为临床防治ED提供参考。方法回顾性分析2021年1月至2023年6月新乡医学院第一附属医院收治的120例BPH术后患者的临床资料,根据术后是否发生ED分组,其中ED组60例,非ED组60例。比较两组患者的临床资料,采用Logistic回归方程分析BPH患者术后ED发生的影响因素,采用R-3.4.5软件语言建立列线图模型,绘制受试者工作特征曲线(ROC)、校准曲线、曲线下面积(AUC)、决策曲线(DCA)分析列线图模型预测效能,采用递归分割法建立ED发生风险分层系统。结果ED组患者中合并高血压、抑郁症、糖尿病、下尿路症状≥2项的例数占比分别为46.67%、31.67%、43.33%、45.00%,明显高于非ED组的28.33%、15.00%、23.33%、25.00%,差异均有统计学意义(P<0.05);ED组患者的一氧化氮(NO)、睾酮(T)水平分别为(40.42±5.56)nmol/mL、(2.11±0.60)μg/L,明显低于非ED组的(46.78±6.12)nmol/mL、(2.72±0.81)μg/L,而内皮素-1(ET-1)水平为(71.88±8.89)ng/L,明显高于非ED组的(60.02±10.23)ng/L,差异均有统计学意义(P<0.05);ED组患者收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)分别为(7.56±2.27)cm/s、(20.23±3.58)cm/s、0.59±0.17,明显小于非ED组的(10.22±2.69)cm/s、(25.51±4.36)cm/s、0.78±0.23,差异均有统计学意义(P<0.05);Logistic回归分析结果提示,高血压、抑郁症、糖尿病、NO、ET-1、T均是BPH术后ED发生风险的影响因素(P<0.05);基于上述影响因素构建的BPH术后ED发生风险的列线图预测模型的AUC为0.862,95%CI为0.796~0.927;DCA曲线显示该模型具有正向净获益;危险分层分析结果显示,高风险患者ED发生率为85.71%(36/42),高于中等风险的32.56%(14/43)和低风险的28.57%(10/35),差异有统计学意义(P<0.05)。结论高血压、抑郁症、糖尿病、NO、ET-1、T均是BPH术后ED发生风险的影响因素,基于上述影响因素建立的预测模型预测效能较高,基于预测模型的危险分层系统能较好地识别高危险患者,便于指导临床治疗。

Erectile dysfunction is associated with subclinical carotid vascular disease in young men lacking widely-known risk factors

This study aimed to gain insight into the underlying pathogenesis of erectile dysfunction in young men under the age of 40 years without widely-known risk factors. Compared with normal controls, patients with erectile dysfunction had increased carotid intima- media thickness, fasting levels of blood glucose and insulin, and homeostatic model assessment index, as well as lower flow-mediated vasodilation and testosterone levels （P 〈 0.05）, though all of these values were within their respective normal range. Multivariate logistic regression analysis identified carotid intima-media thickness, flow-mediated vasodilation, insulin level, and homeostatic model assessment index as significant predictors of erectile dysfunction. Young men with flow-mediated vasodilation 〈10.65% were 11.645 times more likely to have erectile dysfunction, young men with carotid intima-media thickness 〉0.623 mm had a 4.16-fold, and young men with homeostatic model assessment index 〉1.614 had a 5.993-fold greater risk of having erectile dysfunction. In conclusions, in young men with normal results from general clinical screening, an increased carotid intima-media thickness and homeostatic model assessment index and reduced flow-mediated vasodilation were associated with a higher incidence of erectile dysfunction. Erectile dysfunction may appear before the detection of traditional cardiovascular risk factors and may be the earliest clinical sign of subclinical cardiovascular disease.

Biomarkers, erectile dysfunction, and cardiovascular risk prediction： the latest of an evolving concept

A number of circulating and imaging biomarkers are robustly associated with cardiovascular （CV） risk. The overall expectation from a biomarker in the erectile dysfunction （ED） setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal.

Association between MTHFR c.677C>T variant and erectile dysfunction among males attending fertility clinic

Genetic risk factors have been shown to contribute to the development of sexual dysfunction.However,the role of methylenetetrahydrofolate reductase(MTHFR)gene variants in the risk of erectile dysfunction(ED)remains unclear.In this study,we recruited 1254 participants who underwent ED assessed by the International Index of Erectile Function-5.The MTHFR c.677C>T variant was also measured by fluorescence polymerase chain reaction(PCR).No significant difference in the genotypic frequency of the MTHFR C677T polymorphism(CC,CT,and TT)was observed between men from the ED and non-ED groups.In addition,on binary logistic regression analysis,both crude and adjusted models showed that the risk of ED was not significantly associated with the C677T polymorphism.Interestingly,a significantly higher frequency of the 677TT polymorphism was found in severe and moderate ED(P=O.02).The positive correlation between the MTHFR 677TT polymorphism and severe ED was confirmed by logistic regression analysis,even after adjusting for potential confounders(odds ratio[OR]=2.46,95%confidence interval[CI]:1.15-5.50,P=0.02).These findings suggest a positive correlation between the MTHFR 677TT polymorphism and the risk of severe ED.Identification of MTHFR gene polymorphisms may provide complementary information for ED patients during routineclinicaldiagnosis.

勃起功能障碍与血管内皮功能相关性研究及其影响因素

目的:探讨血管内皮功能损害与勃起功能障碍(erectile dysfunction,ED)的相关性及其影响因素。方法:选择中山大学附属第一医院泌尿外科就诊的134例ED患者行病史记录,血睾酮、甘油三酯与总胆固醇检测,用彩色多普勒超声检测血管内皮功能,并与对照组(15例健康志愿者)进行比较分析。结果:134例ED患者中97例(72.4%)的血管内皮舒张功能值(flow mediated dilation,FMD)<10%(7.46%±1.66%),与正常对照组相比,差异有统计学意义(P<0.01),血睾酮、甘油三酯与总胆固醇两组差异无统计学意义(P均>0.05),内皮功能影响因素主要有吸烟和运动。结论:大部分青年、中年ED患者与血管内皮舒张功能下降相关,吸烟和缺乏运动可能是ED的主要原因。

骨盆骨折后尿道损伤合并勃起功能障碍的危险因素分析

目的了解骨盆骨折后尿道损伤（PFUDD）患者合并勃起功能障碍（ED）的发病率，并确定其相关危险因素。方法对102例PFUDD患者进行国际勃起功能指数-5（IIEF-5）量表调查，评估伤后至少2年受访者的勃起功能，单因素和多因素分析年龄、创伤原因、骨盆骨折类型、耻骨联合分离、前列腺横向移位、尿道分离长度等因素对PFUDD合并ED风险的影响。结果102例PFUDD患者中合并ED47例（46％），单因素分析显示耻骨联合分离、前列腺横向移位、尿道分离长度和骨折类型4个变量均是ED的危险因素，多因素分析显示耻骨联合分离（OR15．435，95％CI：1．913—130．526，P=0．002）、前列腺横向移位（OR7．732，95％CI：1．589～37．615，P=0．011）和尿道分离长度（OR4．778，95％CI：1．048～21．783，P=0．043）是PFUDD患者合并ED的独立危险因素。结论PFUDD患者合并ED并不少见，耻骨联合分离、前列腺横向移位以及尿道分离长度是PFUDD患者合并ED的独立危险因素。

中国北方城市健康体检汉族人群代谢综合征新危险因素分析

目的探讨新的心血管危险因素非酒精性脂肪肝病(non-alcoholic fatty liver disease NAFLD)和血管性勃起功能障碍(Erectile dysfunction,ED)与代谢综合征(MS)组分的关系。方法从2008—2009年北方城市健康体检人群中随机整群抽样18096例进行调查和血清学检查。采用SPSS13.0统计软件分析探讨新的心血管危险因素NAFLD和ED与MS各主要组分之间的关系。结果本次调查资料完整者共18096例,年龄18～76岁,平均(46.8±10.1)岁。男,10096例,占55.79%,;女,8000例,占44.21%。MS知晓率为8.33%;成年健康体检者MS的患病率为21.18%;MS最常见的组分依次是高尿酸血症、肥胖、高血压和血脂异常。MS及其各组分体质指数(BMI)和腰臀比(WHR)比较,BMI和WHR最高的组分是超重或肥胖、血管性ED、糖尿病前期和高血压;MS伴发NAFLD3721例,患病率为19.67%;以MS伴发NAFLD为因变量,Logistic回归分析结果:年龄、吸烟史、饮酒史等13个变量,差异均有统计学意义(P<0.01)。年龄、吸烟史、饮酒史、DM家族史、BMI、腰围及ALT升高为疾病的危险因素,体育锻炼和职业性体力劳动为其保护因素。血管性ED106例,患病率为1.04%;以MS伴发ED为因变量,Logis-tic回归分析结果:年龄、文化程度、体育锻炼等8个变量,差异均有统计学意义(P<0.01)。年龄、DM家族史、BMI和腰围为疾病的危险因素,文化程度、体育锻炼和职业性体力劳动为其保护因素。结论MS新的心血管危险因素包括NAFLD和ED,它们均与MS各组分间关系密切,可能成为MS的组分;对新的心血管危险因素的控制,为心脑血管疾病的预防提供了新途径。

心血管疾病患者并发勃起功能障碍的危险因素分析

目的：调查男性心血管疾病住院患者的勃起功能,探讨心血管疾病中勃起功能障碍（ED）的发生率及其危险因素与勃起功能的关系。方法：自行设计问卷,对西安交通大学第一、第二附属医院心血管内科住院的男性患者进行问卷调查,测量身高、体重、腰围、臀围、血压等数据;收集个人基本信息、既往史（包括吸烟史、饮酒史,高血压、冠心病、心律失常、心绞痛、心肌梗死病史、糖尿病病史等）,记录代谢参数检查结果。同时以IIEF-5进行勃起功能评分。采用单变量、多变量Logistic回归分析及比值比（OR）确定ED的危险因素。结果：本研究共纳入有效问卷225份,经统计分析发现在整个调查人群中ED的发病率为66.7%。其中轻度、轻中度、中度、重度ED的发病率分别为15.8%、27.0%、17.6%、6.3%。各组别（18～35岁、36～49岁、50～65岁、〉65岁）人群ED的发病率分别为13.6%、39.1%、89.2%、91.2%。单变量Logistic回归显示,心血管疾病并发ED的危险因素包括年龄（OR=3.122,95%CI：2.040～4.779）、吸烟（OR=1.768,95%CI：1.209～2.584）、BMI（OR=1.261,95%CI：1.114～1.427）、总胆固醇（OR=1.77,95%CI：1.339～2.34）、TC/HDL（OR=1.715,95%CI：1.349～2.181）、高血压（OR=1.717,95%CI：1.110～2.658）及冠心病（OR=2.235,95%CI：1.169～4.275）。而多变量Logistic回归分析显示,心血管疾病并发ED的危险因素分别为年龄（OR=4.99,95%CI：2.264～10.998）、经济情况（OR=2.804,95%CI：1.127～6.976）、吸烟（OR=2.109,95%CI：1.179～3.772）、BMI（OR=1.414,95%CI：1.136～1.76）和TC/HDL（OR=2.001,95%CI：1.016～3.943）。结论：在我国心血管疾病男性住院患者中ED的发病率很高,并随着年龄的增长而升高。年龄、吸烟、经济情况、BMI、TC/HDL是ED的危险因素,心血管病与ED存在着共同的危险因素,包括年龄、吸烟、BMI、TC/HDL,而经济情况在研究中被证实与ED关系密切,为以后的研究提供了新的思路。

重视轻症勃起功能障碍的诊治

轻症勃起功能障碍(MSED)在临床实践中常见,但临床医生和患者均对其认识不足,导致就诊率较低。越来越多的研究表明,MSED不仅与不良生活方式和精神心理因素有关,更与血管内皮、代谢、内分泌等器质性病变的早期进展具有相关性。MSED的诊治应参考ED的相关指南,但要注意其自身的特点,充分考虑"共病"的情况;MSED的治疗原则是整体治疗、防治并行与针对病因的个性化方案相结合;心理治疗无效时需要及时进行药物干预。延误MSED的诊治不仅影响生活质量,而且可能延误对潜在重大疾病的诊治。重视MSED的早期诊治,有利于提高对ED发病机制的认识水平,以及预防心血管、代谢等重大相关疾病,对改善男性整体健康具有重要意义。

肾移植患者阴茎勃起功能影响因素分析

目的:研究肾移植对勃起功能的影响,并对相关影响因素进行分析,以期提高移植术后患者的生活质量。方法:对250例肾移植术后移植肾功能良好的已婚男性受者进行勃起功能国际问卷调查,并收集一般临床资料、病史、性生活史和实验室检查资料。应用单因素分析和多因素Logistic回归分析确定对勃起功能有独立的和显著影响的相关因素。结果:212例完成整个调查,114例移植术前为ED(53.8%),移植术后94例被确定为ED(44.3%),两者差异无显著性(P>0.05)。根据ED分度移植前后的变化,91例(42.9%)勃起功能移植前后无变化,93例(43.9%)有改善,28例(13.2%)移植前勃起功能正常的患者移植后减退。Logistic回归分析确定年龄、贫血、糖尿病、周围神经病变、多次移植是独立和显著影响勃起功能的因素,相对危险度分别为3.01、2.01、3.15、3.89、2.67。结论:肾移植后ED的发生率仍较高。移植术后ED的病因是多方面的,年龄、糖尿病、周围神经病变、血红蛋白水平、多次移植是影响勃起功能的主要因素。