男性性功能障碍患者性欲低下的影响因素分析  

Factors for low libido in male patients with sexual dysfunction

作　　者：吕秋晨 王瑞[2] 王祖龙[1] 张天标[2] 郑涛[2] 吕坤龙 南永浩 LU Qiu-chen;WANG Rui;WANG Zu-long;ZHANG Tian-ji;ZHENG Tao;L Kun-long;NAN Yong-hao(Department of Andrology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;Department of Andrology,Zhengzhou University First Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第一附属医院男科,河南郑州450000 [2]郑州大学第一附属医院男科,河南郑州450000

出　　处：《中华男科学杂志》2024年第8期734-737,共4页National Journal of Andrology

摘　　要：目的:分析男性性功能障碍患者性欲低下的影响因素,为临床诊治提供依据。方法:回顾性分析2023年6月至2023年9月郑州大学第一附属医院男科门诊111例性功能障碍患者(包括勃起、射精或者性欲障碍),将以性欲低下为主诉或伴随症状的患者分组至性欲低下组(43例),性欲正常组(68例),所有患者均进行国际勃起功能指数问卷表-5(IIEF-5)、早泄诊断量表(PEDT)、男性13项性欲自评量表、健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及血清相关激素检测(FSH、LH、PRL、T、fT、E2、IGF-1、GH),比较两组基本参数差异,并将差异显著的参数与性欲值进行相关性分析。结果:性欲正常组与性欲低下组相比,IIEF-5评分、PEDT评分、性欲评分和IGF-1值显著增高,GAD-7评分明显降低(P<0.05),而PHQ-9评分、FSH、LH、PRL、T、fT、E2、T/E2及GH值两组间无显著差异(P>0.05)。性欲值与IIEF-5(r=0.28,P<0.01)、PEDT(r=0.29,P<0.01)、IGF-1(r=0.23,P<0.05)呈正相关,与GAD-7(r=-0.21,P<0.05)呈负相关。结论:性欲低下是多因素导致的结果,生殖激素并不能完全解释性欲的变化。IGF-1水平越低、ED及焦虑程度越重发生性欲低下风险越高。Objective:To analyze the factors for low libido in male patients with sexual dysfunction and provide some evidence for the clinical diagnosis and treatment of the condition.Methods:We retrospectively analyzed the clinical data on 111 cases of sexual dysfunction(including disorders in erection,ejaculation or libido)treated in the Zhengzhou University First Hospital from June to September 2023.According to the patients'complaints of low libido or accompanied symptoms,we divided them into a normal libido group(n=68)and a low libido(n=43),obtained their scores on IIEF-5,Premature Ejaculation Diagnostic Tool(PEDT),13-Item Self-Rating Libido Scale for Males(SRLS-M),Patients’Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7),examined the levels of the sexual hormones FSH,LH,PRL,T,free testosterone(fT),E2,?insulin-like growth factor 1(IGF-1)and growth hormone(GH),compared the basic parameters between the two groups,and analyzed their correlation with the libido values.Results:The IIEF-5,PEDT and libido scores and IGF-1 level were significantly higher and the GAD-7 score remarkably lower in the normal than in the low libido group(P<0.05),but no statistically significant differences were observed between the two groups in the PHQ-9 score and the levels FSH,LH,PRL,T,fT,E2,T/E2 and GH(P>0.05).The libido value was correlated positively with the IIEF-5(r=0.28,P<0.01)and PEDT scores(r=0.29,P<0.01)and IGF-1 level(r=0.23,P<0.05),but negatively with the GAD-7 score(r=-0.21,P<0.05).Conclusion:Low libido results from multiple factors,which cannot be fully explained by sexual hormone levels but is closely related to the decreased level of IGF-1 and severity of ED and anxiety.

关 键 词：性功能障碍 性欲低下 胰岛素样生长因子1 生殖激素 焦虑 

分 类 号：R698.1[医药卫生—泌尿科学]