肾脏移植可部分改善尿毒症患者的勃起功能障碍  

Renal transplantation can partially improve the erectile function of patients with uremia

作　　者：王尚乾[1] 任筱寒 龚子旋 王中原 陈浩[1] 谭若芸 顾民[1] 韩志坚[1] WANG Shangqian;REN Xiaohan;GONG Zixuan;WANG Zhongyuan;CHEN Hao;TAN Ruoyun;GU Min;HAN Zhijian(Department of Urology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院泌尿外科,江苏南京210029

出　　处：《现代泌尿外科杂志》2021年第12期998-1000,1004,共4页Journal of Modern Urology

基　　金：国家自然科学基金(No.81800587)。

摘　　要：目的探讨肾脏移植手术对于尿毒症患者勃起功能的改善及影响因素。方法回顾性分析2014年1月至2019年1月在南京医科大学第一附属医院泌尿外科行同种异体肾移植手术的80例男性患者的资料,采用勃起功能国际问卷-5(IIEF-5)记录患者肾功能无异常时期、尿毒症期、肾移植术后1年时的勃起功能情况,比较不同时期勃起功能评分,并进一步将患者按透析、高血压、贫血等指标进行分组,比较其勃起功能。结果IIEF-5总评分在尿毒症时较肾功能无异常时期显著降低(14.71±6.65 vs.21.54±4.58,P<0.001),移植术后1年较尿毒症期显著升高(18.35±6.39 vs.14.71±6.65,P<0.001),但无法恢复到健康时的水平(18.35±6.39 vs.21.54±4.58,P<0.001)。采用血液透析和腹膜透析患者之间同时期IIEF-5评分差异无统计学意义(P>0.05);尿毒症时期伴有贫血的患者,其IIEF-5评分较无贫血患者低(13.65±6.79 vs.17.11±6.57,P=0.062),且在肾移植术后1年时贫血患者与非贫血患者相比在IIEF-5分数上差异具有统计学意义(17.27±7.24 vs.21.00±4.89,P=0.018);肾功能无异常时期患有高血压的患者在尿毒症期和肾移植术后的IIEF-5评分均显著低于无高血压组[尿毒症时期:(13.90±3.86)vs.(17.13±3.81),P=0.002;肾移植术后:(16.72±3.48)vs.(19.95±3.83),P=0.002]。结论肾移植手术可部分恢复因尿毒症引起的男性勃起功能障碍,高血压、贫血可能是移植术后阻碍其性功能恢复的原因。Objective To investigate the effects of renal transplantation on the erectile function of patients with uremia.Methods Clinical data of 80 male patients who underwent renal transplantation in our center during Jan.2014 and Jan.2019 were surveyed with IIEF-5 questionnaire to document and compare their erectile function at different time points(healthy,uremia,and 1 year after renal transplantation).The dialysis,hypertension and anemia data were also analyzed.Results The IIEF-5 score under uremia was lower than that under healthy condition(14.71±6.65 vs.21.54±4.58,P<0.001).Though IIEF-5 score after transplantation was significantly improved(18.35±6.39 vs.14.71±6.65,P<0.001),it did not return to the healthy condition.There was no difference in the IIEF-5 score at different time points under hemodialysis or abdominal dialysis(P<0.05).For those with anemia under uremia,the IIEF-5 score was lower than those without anemia(13.65±6.79 vs.17.11±6.57,P=0.062),and significant difference was observed 1 year after renal transplantation(17.27±7.24 vs.21.00±4.89,P=0.018).Patients with hypertension had significantly lower IIEF-5 score under uremia and after renal transplantation than those without hypertension[under urema:(13.90±3.86)vs.(17.13±3.81),P=0.002;after renal transplantation:(16.72±3.48)vs.(19.95±3.83),P=0.002].Conclusion Renal transplantation can partially restore erectile function.Hypertension and anemia may hinder the recovery of sexual function after transplantation.

关 键 词：肾移植 勃起功能障碍 IIEF-5 尿毒症 

分 类 号：R697.1[医药卫生—泌尿科学]