中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (09): 462-465.doi: 10.3969/j.issn.1671-4091.2016.09.005

• 临床研究 • 上一篇    下一篇

血液透析患者血管内皮损伤及性激素水平对勃起功能的影响

高明1,张连栋2,王子明2,张莉1   

  1. 1. 西安市第四医院肾内科
    2. 西安交通大学第二附属医院泌尿外科
  • 收稿日期:2016-03-21 修回日期:2016-06-21 出版日期:2016-09-12 发布日期:2016-09-12
  • 通讯作者: 张连栋 liandong-zhang@Hotmail.com E-mail:liandong-zhang@Hotmail.com
  • 基金资助:

    本研究部分经费由国家自然科学基金面上项目(批准号：81471446)资助

Impact of vascular endothelial injury and sex hormone level on erectile function in male hemodialysis patients

  • Received:2016-03-21 Revised:2016-06-21 Online:2016-09-12 Published:2016-09-12

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摘要： 目的分析接受维持性血液透析患者血管内皮损伤程度及性激素水平对勃起功能的影响。方法选择维持性血液透析的男性患者83 例，采用勃起功能国际问卷-5(international index for erectile function-5，IIEF-5)将患者分为正常组(A 组)、轻度勃起功能障碍(erectile dysfunction, ED)组(B 组)、中度ED 组(C 组)、重度ED 组(D 组)，分别有15 例、19 例、25 例、24 例，分别对各组钙、磷水平、血压、血管细胞黏附分子-1(vascular cell adhesion molecule-1，VCAM-1)、细胞间黏附分子-1(intercellular adhesion molecule-1，ICAM-1)、血管性血友病因子(von Willebrand factor,vWF)及泌乳素 (prolactin,PRL)、雌二醇(estradiol,E2)及睾酮(testosterone, T)水平进行检测。结果C 组血磷均值高于参考值，D 组血磷、收缩压均值高于参考值。随各组勃起功能下降，各组ICAM-1、VCAM-1 及vWF 水平逐渐升高，组间差异具有统计学意义(F=267.308、182.514、123.929，P 均＜0.001);各组PRL 及E2水平逐渐升高，组间差异具有统计学意义(F=18.756、136.561，P 均＜0.001)，T 水平显著下降(F=24.715，P＜0.001)。相关性分析表明，ICAM-1 与PRL、E2、T 呈现显著相关性(r=0.298，P=0.032；r=0.367，P=0.015；r=-0.394，P=0.023)，VCAM-1 与E2、T 显著相关(r=0.314，P=0.026；r=-0.308，P=0.037)，vWF 与E2、T 显著相关(r=0.295、-0.317，P=0.044、0.032)。结论血管内皮损伤与性激素水平失调密切相关，是导致男性血液透析患者勃起功能障碍发生的重要因素。

关键词: 血液透析, 内皮损伤, 性激素, 勃起功能

Abstract: Objective To analyze the impact of vascular endothelial injury and sex hormone level on erectile function in male hemodialysis patients. Methods A total of 83 cases of male patients undergoing maintenance hemodialysis were enrolled in this study, and were divided into normal group (group A, n=15), mild erectile dysfunction (ED) group (group B, n=19), moderate ED group (group C, n=25), and severe ED group (group D, n=24) based on the International Index for Erectile Function-5 (IIEF-5) scale. Serum ICAM-1, VCAM-1, vWF and prolactin (PRL), estradiol (E2), and testosterone (T) were measured. Results Serum phosphorus in group C and serum phosphorus and systolic blood pressure in group D were higher than the reference levels.With the deterioration of erectile function, ICAM-1, VCAM-1 and vWF increased gradually, significantly different among the groups (F=267.308, 182.514, and 123.929 respectively, P＜0.001); PRL and E2 increased gradually, significantly different among the groups (F=18.756 and 136.561 respectively, P＜0.001); while serum T level decrease significantly (F= 24.715, P＜0.001). Correlation analysis exhibited that ICAM-1 was significantly correlated with PRL, E2 and T (r=0.298, 0.367 and -0.394 respectively; P=0.032, 0.015 and 0.023 respectively), VCAM-1 was significantly correlated with E2 and T (r=0.314 and -0.308 respectively; P= 0.026 and 0.037 respectively), and vWF was significantly correlated with E2 and T (r=0.295 and -0.317 respectively; P=0.044 and 0.032 respectively). Conclusion Vascular endothelial injury is closely related to sex hormone disturbances, which are the important factors for ED in male hemodialysis patients.

Key words: hemodialysis, endothelial injury, sex hormone, erectile function