中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
1期
27-30
,共4页
刘松%陈颖%郝钢跃%贺正一
劉鬆%陳穎%郝鋼躍%賀正一
류송%진영%학강약%하정일
睡眠呼吸暂停低通气综合征%男性%性功能障碍
睡眠呼吸暫停低通氣綜閤徵%男性%性功能障礙
수면호흡잠정저통기종합정%남성%성공능장애
Sleep apnea and hypoventilation syndrome%Male%Sexual dysfunction
目的 探讨男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者性功能障碍的危险因素.方法 采用国际勃起功能指数量表(IIEF-5)评估121例男性22～50岁OSAHS患者性功能,分为性功能正常组(65例)和性功能障碍组(56例).比较两组患者临床资料和多导睡眠图监测结果.部分性功能障碍患者进行持续气道正压(CPAP)治疗后再次以IIEF-5评价性功能.结果 性功能障碍组患者体质量指数(BMI)显著高于性功能正常组[(31.5±3.9) kg/m2与(30.1±3.5) kg/m2,t=6.897,P＜0.01],有糖尿病病史者显著多于性功能正常组(18例与10例,x2=4.750,P＜0.05),晨间血压升高者显著多于性功能正常组(38例与27例,x2 =8.381,P＜0.01)；性功能障碍组患者多导睡眠图监测显示,呼吸紊乱指数(RDI)、最长呼吸暂停时间(Tmax)、最低脉搏血氧饱和度(LSp02)、脉搏血氧饱和度低于90％时间占总睡眠(TST)时间比(T90％)、浅睡眠(S1+S2)占ST比、深睡眠(S3+S4)占TST比、快动眼睡眠(REM)占TST比等指标与性功能正常组之间差异有统计学意义(t值分别为5.290、2.253、3.770、7.536、6.599、3.935和5.536,P均＜0.05).多因素Logistic回归分析显示,糖尿病病史、多导睡眠图监测中S1 +S2占TST比、RDI和LSp02对男性OSAHS患者出现性功能障碍有统计学意义,其OR值(95％可信区间)分别为2.10(1.17 ～5.01)、3.52(1.33 ～ 5.97)、1.45(1.08 ～2.95)和0.86(0.67～0.93),P均＜0.05.20例性功能障碍患者持续气道正压治疗2个月后14例经IIEF-5评分(＞21分)正常.结论 具有糖尿病病史,睡眠结构紊乱S1 +S2占TST比增多、RDI较高和LSpO2较低是男性OSAHS患者发生性功能障碍的独立危险因素.持续气道正压治疗可以显著改善男性OSAHS患者性功能.
目的 探討男性阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者性功能障礙的危險因素.方法 採用國際勃起功能指數量錶(IIEF-5)評估121例男性22～50歲OSAHS患者性功能,分為性功能正常組(65例)和性功能障礙組(56例).比較兩組患者臨床資料和多導睡眠圖鑑測結果.部分性功能障礙患者進行持續氣道正壓(CPAP)治療後再次以IIEF-5評價性功能.結果 性功能障礙組患者體質量指數(BMI)顯著高于性功能正常組[(31.5±3.9) kg/m2與(30.1±3.5) kg/m2,t=6.897,P＜0.01],有糖尿病病史者顯著多于性功能正常組(18例與10例,x2=4.750,P＜0.05),晨間血壓升高者顯著多于性功能正常組(38例與27例,x2 =8.381,P＜0.01)；性功能障礙組患者多導睡眠圖鑑測顯示,呼吸紊亂指數(RDI)、最長呼吸暫停時間(Tmax)、最低脈搏血氧飽和度(LSp02)、脈搏血氧飽和度低于90％時間佔總睡眠(TST)時間比(T90％)、淺睡眠(S1+S2)佔ST比、深睡眠(S3+S4)佔TST比、快動眼睡眠(REM)佔TST比等指標與性功能正常組之間差異有統計學意義(t值分彆為5.290、2.253、3.770、7.536、6.599、3.935和5.536,P均＜0.05).多因素Logistic迴歸分析顯示,糖尿病病史、多導睡眠圖鑑測中S1 +S2佔TST比、RDI和LSp02對男性OSAHS患者齣現性功能障礙有統計學意義,其OR值(95％可信區間)分彆為2.10(1.17 ～5.01)、3.52(1.33 ～ 5.97)、1.45(1.08 ～2.95)和0.86(0.67～0.93),P均＜0.05.20例性功能障礙患者持續氣道正壓治療2箇月後14例經IIEF-5評分(＞21分)正常.結論 具有糖尿病病史,睡眠結構紊亂S1 +S2佔TST比增多、RDI較高和LSpO2較低是男性OSAHS患者髮生性功能障礙的獨立危險因素.持續氣道正壓治療可以顯著改善男性OSAHS患者性功能.
목적 탐토남성조새성수면호흡잠정저통기종합정(OSAHS)환자성공능장애적위험인소.방법 채용국제발기공능지수량표(IIEF-5)평고121례남성22～50세OSAHS환자성공능,분위성공능정상조(65례)화성공능장애조(56례).비교량조환자림상자료화다도수면도감측결과.부분성공능장애환자진행지속기도정압(CPAP)치료후재차이IIEF-5평개성공능.결과 성공능장애조환자체질량지수(BMI)현저고우성공능정상조[(31.5±3.9) kg/m2여(30.1±3.5) kg/m2,t=6.897,P＜0.01],유당뇨병병사자현저다우성공능정상조(18례여10례,x2=4.750,P＜0.05),신간혈압승고자현저다우성공능정상조(38례여27례,x2 =8.381,P＜0.01)；성공능장애조환자다도수면도감측현시,호흡문란지수(RDI)、최장호흡잠정시간(Tmax)、최저맥박혈양포화도(LSp02)、맥박혈양포화도저우90％시간점총수면(TST)시간비(T90％)、천수면(S1+S2)점ST비、심수면(S3+S4)점TST비、쾌동안수면(REM)점TST비등지표여성공능정상조지간차이유통계학의의(t치분별위5.290、2.253、3.770、7.536、6.599、3.935화5.536,P균＜0.05).다인소Logistic회귀분석현시,당뇨병병사、다도수면도감측중S1 +S2점TST비、RDI화LSp02대남성OSAHS환자출현성공능장애유통계학의의,기OR치(95％가신구간)분별위2.10(1.17 ～5.01)、3.52(1.33 ～ 5.97)、1.45(1.08 ～2.95)화0.86(0.67～0.93),P균＜0.05.20례성공능장애환자지속기도정압치료2개월후14례경IIEF-5평분(＞21분)정상.결론 구유당뇨병병사,수면결구문란S1 +S2점TST비증다、RDI교고화LSpO2교저시남성OSAHS환자발생성공능장애적독립위험인소.지속기도정압치료가이현저개선남성OSAHS환자성공능.
Objective To investigate the risk factors of sexual dysfunction in male patients with obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods One hundred and twenty-one OSAHS male patients aged 22-50 years were stratified into two groups based on scores on the rating scales of international index of erectile function-5 (IIEF-5).Patients' characteristics and polysomnography data of the sexual dysfunction group (n =56) were compared with that of the normal group (n =65).Continuous positive airway pressure(CPAP) treatment was carried out in some patients with abnormal sexual function.Results There were significant differences between the two groups in body mass index (BMI),history of hypertensive disease and diabetes mellitus,the rise of morning blood pressure,respiratory disturbance index (RDI),the longest apnea time(Tmax),the lowest oxygen saturation(LSpO2),percentage of recording time with oxygen saturation of 90％ or less(T90％),slow wave sleep(S1 + S2) over total sleep time(TST),rapid wave sleep (S3 + S4) time over TST,and rapid eye movement (REM) sleep time over TST in bivariate analysis (P ＜ 0.05).There were statistical significance of the history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2shown in Logistics regression analysis,and ORs were 2.10 (1.17-5.01),3.52 (1.33-5.97),1.45 (1.08-2.95),and 0.86 (0.67-0.93) respectively (P ＜ 0.05).Moreover,20 OSAHS patients with sexual dysfunction were revaluated after the CPAP treatment in two months,and 14 patients returned to the normal scores.Conclusion The history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2 were independent risk factors for sexual dysfunction in male patients with OSAHS,and treatment with CPAP could significantly improve sexual function in male patients.
