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目的探讨男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者性腺激素的变化和勃起功能障碍(ED)的关系,评估连续气道正压通气(CPAP)对OSAHS患者勃起功能障碍的疗效。方法选择2006年12月至2008年5月兰州大学第一医院46例OSAHS患者和30名健康对照组,使用国际勃起功能指数-5量表(IIEF-5)和采用化学发光免疫分析法分别评估受试者的勃起功能和测定其血清卵泡刺激素(FSH)、黄体生成素(LH)及睾丸酮(T)。对合并ED的22例OSAHS患者使用CPAP治疗3个月后再次评估其勃起功能和测定FSH、LH、T。结果与对照组相比,OSAHS组IIEF-5评分[(19.7±3.41)分对(22.2±1.47)分)]、FSH[(9.65±1.08)U/L对(10.90±1.12)U/L)]、LH(9.97±0.98)U/L对(11.98±1.52)U/L]及T[(8.96±0.89)nmol/L对(10.67±1.01)nmol/L)明显低于对照组(P均<0.01)。IIEF-5评分与AHI呈显著负相关(r=-0.621,P<0.01),与LSaO2正相关(r=0.596,P<0.01);血清FSH、LH和T与AHI均呈显著负相关(r分别为-0.541、-0.479和-0.637,P均<0.01),与LSaO2均呈正相关(r分别为0.542、0.588和0.546,P均<0.01);IIEF-5评分与血清T呈显著正相关(r=0.601,P<0.01)。经CPAP治疗后,合并ED的OSAHS患者IIEF-5评分和血清性激素均明显改善,且对CPAP耐受良好。结论男性OSAHS患者存在着ED和性激素的下降,与AHI和低氧相关;CPAP治疗能改善患者ED和提高性激素。
Objective To investigate the relationship between sex hormones and erectile dysfunction (ED) in male patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and evaluate the effect of continuous positive airway pressure (CPAP) on erectile dysfunction in patients with OSAHS. Methods 46 patients with OSAHS and 30 healthy controls from the First Hospital of Lanzhou University from December 2006 to May 2008 were enrolled in the study. The International Erectile Dysfunction Index-5 Scale (IIEF-5) and chemiluminescence immunoassay Subjects’ erectile function and determination of their serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T). Twenty-two OSAHS patients with ED were assessed for erectile function and FSH, LH, and T after 3 months of CPAP treatment. Results Compared with the control group, the scores of IIEF-5 in OSAHS group were significantly higher than those in control group (19.7 ± 3.41 vs 22.2 ± 1.47, FSH (9.65 ± 1.08) U / L vs. (10.90 ± 1.12) U / L) ], L (9.97 ± 0.98) U / L vs (11.98 ± 1.52) U / L] and T [(8.96 ± 0.89) nmol / L vs (10.67 ± 1.01) nmol / L) <0.01). There was a significant negative correlation between IIEF-5 and AHI (r = -0.621, P <0.01), positive correlation with LSaO2 (r = 0.596, P <0.01) (-0.541, -0.479 and -0.637, respectively, P <0.01), and had positive correlation with LSaO2 (r = 0.542,0.588 and 0.546, respectively, P <0.01). There was a significant positive correlation between IIEF-5 and serum T r = 0.601, P <0.01). After CPAP treatment, OSAHS with ED in patients with IIEF-5 score and serum sex hormones were significantly improved, and CPAP well tolerated. Conclusions The decline of ED and sex hormones in male patients with OSAHS is associated with AHI and hypoxia. CPAP treatment can improve ED and increase sex hormones.