327例男性糖尿病患者阳痿的病因分析  

The etiology of impotence in 327 diabetic male adults

作　　者：郑辉[1] 李光伟[1] 范文立[2] 张学文[3] 陈仕明[1] 王俊宏[4] 年晓萍[5] 王延玲[6] 潘孝仁[1] 

机构地区：[1]中日友好医院内分泌科,北京100029 [2]中华预防医学会 [3]中日友好医院超声科,北京100029 [4]河南省平顶山市第一人民医院 [5]新疆克拉玛依市第二人民医院 [6]中日友好医院心理科,北京100029

出　　处：《中华内科杂志》1999年第8期546-549,共4页Chinese Journal of Internal Medicine

摘　　要：目的　分析导致男性糖尿病患者阳痿的可能病因。方法　对 3 2 7例年龄在 2 5～ 70岁的男性糖尿病患者详细询问病史 ,进行眼底及神经系统检查 ,阴茎血管病变的超声检查及性激素等测定 ,以明尼苏达多项个性测验 (MMPI)进行心理因素分析。结果　阳痿病人 12 9例 ,2 5～ 3 4岁、3 5～ 4 4岁、4 5～ 5 4岁、5 5～ 70岁年龄段糖尿病阳痿发生率分别为 9.7%、3 4.2 %、4 8.0 %、62 .7%。其中 66例( 5 1 2 % )伴心理障碍 ,79例 ( 61 2 % )伴神经病变 ,3 1例 ( 2 4 0 % )伴阴茎动脉血管病变 ,5例 ( 3 9% )伴阴茎静脉回流障碍 ,2例 ( 1.6% )服用了可能引起阳痿的药物。糖尿病阳痿组糖化血红蛋白、自主神经病变、周围神经病变、增殖期视网膜病变发生率均显著高于糖尿病不伴阳痿组 (P <0 .0 5 )。MMPI结果异常在糖尿病阳痿组明显高于糖尿病不伴阳痿组。两组病人吸烟、饮酒、血睾酮水平在统计学上差异均无显著性 (P >0 .0 5 )。结论　糖尿病阳痿病因为多因素 ,尤以神经病变最常见 ,血管病变和心理因素也可能起重要作用。Objective To investigate the etiology of impotence in diabetic male adults. Methods 327 diabetic men aged 20～70 years were interviewed; 129 (39.6%) of them complained of impotence. All the 129 patients were initially evaluated by diabetologists and then underwent psychosexual assessment by psychiatrists. In addition, evaluation for retinopathy, neuropathy, vascular disease and sex hormone level was carried out. Results The 327 diabetic patients were divided into four age ranges 25～34, 35～44, 45～54, and 55～70. The frequency of diabetic impotence in these groups was 9.7%, 34.2%, 48.0%, 62.7% respectively. Neuropathy was found in 79 (61.2%), psychogenic factor contributed in 66 (51.2%), vascular factor was present in 31 (24 0%), leakage of penile venous cavernosa occurred in 5 (3.9%), and treatment with impotence- related medications was the contributing factor in 2 (1.6%). There are significant differences of glycosylated hemoglobin, peripheral neuropathy, autonomic neuropathy, and proliferative retinopathy between impotent and potent diabetic patients. The degree of psychological problem is more serious in the diabetic impotent patients than in potent patients according to Minnesota multiphasic personality inventory (MMPI) test. No significant difference was found in smoking, alcohol and plasma testosterone level. Conclusion The etiology of diabetic impotence is multifactorial. Neuropathy is the main cause, but vascular and psychological factors also contribute to it significantly.

关 键 词：糖尿病 阳痿 病因 发生率 

分 类 号：R587.1[医药卫生—内分泌] R695.102[医药卫生—内科学]