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目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者与勃起功能障碍(ED)之间的相关性。方法:OSAHS患者60例,纳入观察组;门诊体检健康志愿者60例,纳入对照组,采用PSG睡眠监测仪和NPT同步监测两组患者睡眠状态及阴茎勃起情况,包括呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(min Sa O2)和阴茎血容积变化率(%)。硝酸还原酶法、比色法分别检测NO、i NOS浓度,ECLIA法检测血清睾酮(T)、游离睾酮(FT)、卵泡刺激素(FSH)、黄体生成激素(LH)、催乳素(PRL)水平,国际勃起功能指数评分5项(IIEF-5)评估男性OSAHS患者ED的发病率,并对数据进行相关分析。结果:OSAHS组T(2.10±2.42)、FT(9.76±2.33)、NO(72.51±11.74)、iN OS(25.32±11.57)、minS aO 2(71.23±5.71)、阴茎血容积变化率(158.36±32.87),与对照组相比,差异有非常显著的统计学意义(P<0.01),OSAHS组AHI(45.75±11.92)显著高于对照组(P<0.05)。OSAHS患者ED的发生率显著高于对照组(P<0.01),重度ED患者NO(32.57±6.33)、iN OS(8.06±1.01)、阴茎血容积变化率(135.56±16.92)及IIEF-5总分(5.3±2.3)明显低于轻中度ED患者(P<0.01)。结论:OSAHS与ED有明显的相关性,NO升高、低氧血症、T降低可能是OSAHS患者导致ED的机制。
Objective: To investigate the correlation between obstructive sleep apnea-hypopnea syndrome (OSAHS) and erectile dysfunction (ED). Methods: Sixty OSAHS patients were enrolled in the observation group. Sixty healthy outpatients were enrolled in the control group. The sleep status and penile erection of both groups were monitored by PSG sleep monitor and NPT, including apnea-hypopnea index (AHI ), Minimum arterial oxygen saturation (min Sa O2) and penile blood volume change (%). Nitric acid reductase and colorimetric method were used to detect the concentration of NO and iNOS respectively. The levels of serum testosterone (T), free testosterone (FT), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) Level, the international erectile function index score 5 (IIEF-5) to assess the incidence of ED in male OSAHS patients, and data correlation analysis. Results: The changes of T (2.10 ± 2.42), FT (9.76 ± 2.33), NO (72.51 ± 11.74), iN OS (25.32 ± 11.57), minS aO 2 (71.23 ± 5.71) 32.87). There was a significant difference between the two groups (P <0.01). The AHI of OSAHS group (45.75 ± 11.92) was significantly higher than that of the control group (P <0.05). The incidence of ED in OSAHS patients was significantly higher than that in the control group (P <0.01). The levels of NO (32.57 ± 6.33), iNOS (8.06 ± 1.01), penile blood volume change (135.56 ± 16.92) and IIEF-5 (5.3 ± 2.3) was significantly lower than mild to moderate ED patients (P <0.01). Conclusion: There is a significant correlation between OSAHS and ED. Elevated NO, hypoxemia and decreased T may be the mechanism of ED in patients with OSAHS.