CAJ | 학술논문

目的了解垂体腺瘤男性患者性功能障碍(SD)的发病特征和影响因素.方法回顾性调查和分析86例男性垂体腺瘤患者术前性功能情况,总结不同类型垂体腺瘤男性患者SD的发病特征,分析SD与年龄、肿瘤类型、侵袭性、大小、血泌乳素水平和睾酮水平的相关性.结果垂体腺瘤男性患者SD的发生率为80.2％( 69/86).其中,功能性垂体腺瘤患者SD发生率为84.6％ (66/78)；无功能性垂体腺瘤患者SD发生率为37.5％( 3/8).功能性垂体腺瘤患者中,泌乳素腺瘤组(PRL组)勃起功能障碍(ED)发生率最高,达92.1％ (35/38),明显高于促性腺激素腺瘤组(FSH组)和生长激素腺瘤组(GH组)(P＜0.05).FSH组以性欲低下为主,发生率78.3％ (18/23).GH组ED发生率达70.6％( 12/17),其性欲低下和射精功能障碍的发生率明显低于PRL组和FSH组(P＜0.05).Logistic回归分析结果显示,垂体腺瘤男性性功能障碍与腺瘤病理类型的相关性有统计学意义(P＜0.05),而与年龄、肿瘤大小、侵袭性、血清泌乳素及睾酮水平的相关性差异无统计学意义(P＞0.05).结论垂体腺瘤男性ED发生率很高,尤其是功能性垂体腺瘤.不同类型功能性垂体腺瘤男性性功能障碍的临床特征有所差异,泌乳素腺瘤ED发生率最高.腺瘤的病理类型是性功能障碍的主要影响因素.
목적 료해수체선류남성환자성공능장애(SD)적발병특정화영향인소.방법 회고성조사화분석86례남성수체선류환자술전성공능정황,총결불동류형수체선류남성환자SD적발병특정,분석SD여년령、종류류형、침습성、대소、혈비유소수평화고동수평적상관성.결과 수체선류남성환자SD적발생솔위80.2％( 69/86).기중,공능성수체선류환자SD발생솔위84.6％ (66/78)；무공능성수체선류환자SD발생솔위37.5％( 3/8).공능성수체선류환자중,비유소선류조(PRL조)발기공능장애(ED)발생솔최고,체92.1％ (35/38),명현고우촉성선격소선류조(FSH조)화생장격소선류조(GH조)(P＜0.05).FSH조이성욕저하위주,발생솔78.3％ (18/23).GH조ED발생솔체70.6％( 12/17),기성욕저하화사정공능장애적발생솔명현저우PRL조화FSH조(P＜0.05).Logistic회귀분석결과현시,수체선류남성성공능장애여선류병리류형적상관성유통계학의의(P＜0.05),이여년령、종류대소、침습성、혈청비유소급고동수평적상관성차이무통계학의의(P＞0.05).결론 수체선류남성ED발생솔흔고,우기시공능성수체선류.불동류형공능성수체선류남성성공능장애적림상특정유소차이,비유소선류ED발생솔최고.선류적병리류형시성공능장애적주요영향인소.
Objective To explore the clinical features and related factors of sexual dysfunctions in male patients with pituitary adenomas.Methods The questionnaires of sexual functions were collected from 86 male patients with pituitary adenomas. We examined the clinical features of sexual dysfunctions and analyzed the correlations between sexual behaviors and age,tumor type,invasiveness,tumor size,serum levels of prolactin (PRL) and testosterone.Results The incidence of sexual dysfunctions was 80.2％ (69/86).Sexual dysfunctions were found in 84.6％ (66/78) of the patients with functioning pituitary adenomas and 37.5％ (3/8) of those with non-functioning pituitary adenoma respectively.In the PRL group,the incidence of erectile dysfunctions was 92.1％ (35/38) and it was higher than those in the FSH (folliclestimulating hormone) and GH (growth hormone) groups (P ＜ 0.05).In the FSH group,the incidence of reduced sexual desire was 78.3％ (18/23).In the GH group,the incidence of erectile dysfunctions was 70.6％ ( 12/17 ) and the incidence of reduced sexual desire or ejaculation dysfunction was lower than that of the PRL/FSH group (P ＜ 0.05).Conclusion The incidence of sexual dysfunctions is quite high in males with pituitary adenomas,especially for those with functioning pituitary adenomas.The clinical features of sexual dysfunctions vary in different types of functioning pituitary adenoma. The incidence of erectile dysfunctions is the highest in the PRL group.Pathological type of pituitary tumors is a major risk factor of sexual dysfunctions.