影响男性阻塞性睡眠呼吸暂停综合征患者阴茎勃起功能障碍的因素

doi:10.3969/j.issn.2095-9400.2020.06.013

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摘要目的：探讨引起男性阻塞性睡眠呼吸暂停综合征（OSAS）患者勃起功能障碍（ED）的因素及其可能机制。方法：经多导睡眠监测仪（PSG）及同步夜间阴茎勃起（NPT）测定，90例男性OSAS患者中合并ED患者48例（ED组），无ED者42例（OSAS组）。所有研究对象于次日清晨测定血清睾酮（TT）、促泌乳素（PRL）、雌二醇（E2）、卵泡刺激素（FSH）、促黄体生成素（LH）、血清一氧化氮（NO）、一氧化氮合酶（NOS）浓度。结果：2组间BMI差异有统计学意义（P＜0.05），而性激素水平差异均无统计学意义（P＞0.05），但ED组患者的NO、NOS水平较OSAS组患者明显降低（P＜0.05），且logistic回归分析发现，肥胖、TT和NO是影响男性OSAS勃起功能障碍的主要因素（P＜0.05）。其中肥胖是危险因素，而TT、NO则是保护因素。结论：男性OSAS患者发生ED可能与肥胖、TT和NO有关，OSAS患者体内NO水平可能在维持其勃起功能中起着关键性作用。

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关键词 ：睡眠呼吸暂停综合征, 勃起功能障碍, 肥胖, 性激素, 一氧化氮

Abstract：Objective: To investigate the factors that cause penile erectile dysfunction (ED) in male patients with obstructive sleep apnea syndrome (OSAS) and its possible mechanism. Methods: As measured by polysomnography (PSG) and simultaneous nocturnal penile erection (NPT), of 90 male OSAS patients 48 patients were with ED (ED group) and 42 patients without ED (OSAS group). The concentrations of serum testosterone (TT), prolactin (PRL), estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), nitric oxide (no) and nitric oxide synthetase (NOS) were measured in the next morning. Results: Compared between the two groups, there was significant difference in BMI (P<0.05), but not in sex hormone levels (P>0.05). However, the levels of NO and NOS in the ED group were significantly lower than those in the OSAS group (P<0.05), and logistic regression analysis showed that obesity, TT and NO were the main factors affecting erectile dysfunction in male OSAS (all P<0.05). Obesity was a risk factor, while TT and NO were protective factors. Conclusion: The occurrence of ED in male OSAS patients may be related to obesity, TT and NO. It was speculated that the level of NO in OSAS patients may play a key role in maintaining their erectile function.

Key words： obstructive sleep apnea syndrome erectile dysfunction obesity sex hormone nitric oxide

收稿日期: 2019-11-02

作者简介: 李国平（1976-），男，浙江杭州人，副主任医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2020.06.013 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I6/493

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