江苏大学附属人民医院耳鼻咽喉-头颈外科;
目的:探讨男性阻塞性睡眠呼吸暂停(OSA)患者性功能改变的研究方法及影响因素。方法:对81例男性OSA患者,年龄(40.5±8.6)岁与35例健康志愿者,年龄(38.8±10)岁,采用亚利桑那性体验量表(ASEX)与Epworth嗜睡量表(ESS)问卷调查。以ASEX性驱动力项目评分4分归为性驱动力下降组[n=32,年龄(41.97±8.88)岁],评分<4归为非性驱动力下降组[n=49,年龄(39.49±8.29)岁],比较患者一般特征与PSG数据。将性驱动力评分与PSG数据做多元线性回归,评价影响性冲动能力因素。结果:OSA组患者ESS评分[(8±5)vs(5±4),P<0.05)]、ASEX评分[(10±2)vs(15±4),P<0.05)]均显著高于对照组;OSA患者中性驱动力下降组ESS评分[(9±5)vs(6±5),P<0.05)]、血氧饱和度低于90%时间(SIT90)[(41.01±26.95)vs(21.87±19.03),P<0.05)]显著高于非性驱动力下降组。多元回归分析显示年龄(β=0.25,P<0.001)、SIT90(β=0.4,P<0.001)影响OSA患者性冲动力评分。结论:OSA影响男性性功能的各个方面,其中以性驱动力下降最突出;夜间缺氧时间及年龄是OSA患者性驱动力下降的独立危险因素;性驱动力下降可视为OSA的一种主要临床症状。
221 | 6 | 5 |
下载次数 | 被引频次 | 阅读次数 |
[1]Young T,Palta M,Dempsey J,et al.The occurrence of sleepdisordered breathing among middle-aged adults.N Engl J Med,1993,328(17):1230-1235.
[2]Aasm.American Academy of Sleep Medicine.International Classification of Sleep Disorders,3rd ed.Darien,IL:American Academy of Sleep Medicine,2014.53-61.
[3]Appleton SL,Vakulin A,Martin SA,et al.Hypertension is associated with undiagnosed OSA during rapid eye movement sleep.Chest,2016,150(3):495-505.
[4]Mesarwi O,Polak J,Jun J,et al.Sleep disorders and the development of insulin resistance and obesity.Endocrinol Metab Clin North Am,2013,42(3):617-634.
[5]Won CH,Chun HJ,Chandra SM,et al.Severe obstructive sleep apnea increases mortality in patients with ischemic heart disease and myocardial injury.Sleep Breath,2013,17(1):85-91.
[6]Lee CH,Khoo SM,Chan MY,et al.Severe obstructive sleep apnea and outcomes following myocardial infarction.J Clin Sleep Med,2011,7(6):616-621.
[7]Nieto FJ,Peppard PE,Young T,et al.Sleep-disordered breathing and cancer mortality:Results from the Wisconsin Sleep Cohort Study.Am J Respir Crit Care Med,2012,186(2):190-194.
[8]Jacobsen JH,Shi L,Mokhlesi B.Factors associated with excessive daytime sleepiness in patients with severe obstructive sleep apnea.Sleep Breath,2013,17(2):629-635.
[9]Lagrotte C,Fernandez-Mendoza J,Calhoun S L,et al.The relative association of obstructive sleep apnea,obesity and excessive daytime sleepiness with incident depression:A longitudinal,population-based study.Int J Obes(Lond),2016,40(9):1397-1404.
[10]Guilleminault C,Simmons FB,Motta J,et al.Obstructive sleep apnea syndrome and tracheostomy.Long-term follow-up experience.Arch Intern Med,1981,141(8):985-988.
[11]Guilleminault C.Sleep apnea syndromes:Impact of sleep and sleep states.Sleep,1980,3(3-4):227-234.
[12]Santamaria JD,Prior JC,Fleetham JA.Reversible reproductive dysfunction in men with obstructive sleep apnoea.Clin Endocrinol(Oxf),1988,28(5):461-470.
[13]Martin SA,Atlantis E,Lange K,et al.Predictors of sexual dysfunction incidence and remission in men.J Sex Med,2014,11(5):1136-1147.
[14]Petersen M,Kristensen E,Berg S,et al.Sexual function in male patients with obstructive sleep apnoea.Clin Respir J,2010,4(3):186-191.
[15]Budweiser S,Luigart R,Jorres RA,et al.Long-term changes of sexual function in men with obstructive sleep apnea after initiation of continuous positive airway pressure.J Sex Med,2013,10(2):524-531.
[16]Zhang XB,Lin QC,Zeng HQ,et al.Erectile dysfunction and sexual hormone levels in men with obstructive sleep apnea:Efficacy of continuous positive airway pressure.Arch Sex Behav,2016,45(1):235-240.
[17]Taken K,Ekin S,Arisoy A,et al.Erectile dysfunction is a marker for obstructive sleep apnea.Aging Male,2016,19(2):102-105.
[18]Jitkritsadakul O,Jagota P,Bhidayasiri R.Postural instability,the absence of sexual intercourse in the past month,and loss of libido are predictors of sexual dysfunction in Parkinson's disease.Parkinsonism Relat Disord,2015,21(1):61-67.
[19]Quinta GA,Nobre PJ.Prevalence of sexual problems in Portugal:Results of a population-based study using a stratified sample of men aged 18 to 70 years.J Sex Res,2014,51(1):13-21.
[20]Corona G,Rastrelli G,Ricca V,et al.Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction.J Sex Med,2013,10(4):1074-1089.
[21]Mcgahuey CA,Gelenberg AJ,Laukes CA,et al.The Arizona Sexual Experience Scale(ASEX):reliability and validity.J Sex Marital Ther,2000,26(1):25-40.
[22]Briki M,Haffen E,Monnin J,et al.Sexual dysfunction and depression:Validity of a French version of the ASEX scale.Encephale,2014,40(2):114-122.
[23]Jitkritsadakul O,Jagota P,Bhidayasiri R.The Arizona Sexual Experiences Scale:A validity and reliability assessment of the Thai translation(ASEX-Thai)in Parkinson's disease.J Parkinsons Dis,2014,4(2):205-210.
[24]Nakhli J,El Kissi Y,Bouhlel S,et al.Reliability and validity of the Arizona sexual experiences scale-Arabic version in Tunisian patients with schizophrenia.Compr Psychiatry,2014,55(6):1473-1477.
[25]Mykletun A,Dahl AA,O'Leary MP,et al.Assessment of male sexual function by the Brief Sexual Function Inventory.BJU Int,2006,97(2):316-323.
[26]Soykan A.The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis.Int J Impot Res,2004,16(6):531-534.
[27]朱荣鑫,张向荣,侯钢,等.亚利桑那性体验量表(Arizona Sexual Experience Scale ASEX)评价精神分裂症患者性功能障碍的信度、效度初步研究.中华医学会第十次全国精神医学学术会议论文汇编.南京:2012.
[28]Martin SA,Haren MT,Middleton SM,et al.The Florey Adelaide Male Ageing Study(FAMAS):Design,procedures and participants.BMC Public Health,2007,7:126.
[29]Dewan NA,Nieto FJ,Somers VK.Intermittent hypoxemia and OSA:Implications for comorbidities.Chest,2015,147(1):266-274.
[30]Martin S,Haren M,Taylor A,et al.Cohort profile:The Florey Adelaide Male Ageing Study(FAMAS).Int J Epidemiol,2007,36(2):302-306.
[31]Stokes VJ,Anderson RA,George JT.How does obesity affect fertility in men-and what are the treatment options?Clin Endocrinol(Oxf),2015,82(5):633-638.
[32]Abraham G,Vlatkovic D.Sleep and sexuality.Rev Med Suisse,2006,2(58):789-791.
[33]Hirshkowitz M,Schmidt MH.Sleep-related erections:Clinical perspectives and neural mechanisms.Sleep Med Rev,2005,9(4):311-329.
[34]Gambineri A,Pelusi C,Pasquali R.Testosterone levels in obese male patients with obstructive sleep apnea syndrome:Relation to oxygen desaturation,body weight,fat distribution and the metabolic parameters.J Endocrinol Invest,2003,26(6):493-498.
[35]Luboshitzky R,Lavie L,Shen-Orr Z,et al.Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea.Obes Res,2005,13(4):780-786.
[36]Luboshitzky R,Lavie L,Shen-Orr Z,et al.Pituitary-gonadal function in men with obstructive sleep apnea.The effect of continuous positive airways pressure treatment.Neuro Endocrinol Lett,2003,24(6):463-467.
[37]Luboshitzky R,Aviv A,Hefetz A,et al.Decreased pituitary-gonadal secretion in men with obstructive sleep apnea.J Clin Endocrinol Metab,2002,87(7):3394-3398.
[38]Zielinski J,Zgierska A,Polakowska M,et al.Snoring and excessive daytime somnolence among Polish middle-aged adults.Eur Respir J,1999,14(4):946-950.
[39]Mitchell KR,Mercer CH,Ploubidis GB,et al.Sexual function in Britain:Findings from the third National Survey of Sexual Attitudes and Lifestyles(Natsal-3).Lancet,2013,382(9907):1817-1829.
基本信息:
DOI:10.13263/j.cnki.nja.2017.10.004
中图分类号:R698;R766
引用信息:
[1]蒋康伦,钱炜,林志强等.阻塞性睡眠呼吸暂停对男性患者性功能影响的临床研究[J].中华男科学杂志,2017,23(10):883-888.DOI:10.13263/j.cnki.nja.2017.10.004.
基金信息:
江苏省六大人才高峰项目(2011-WSN021D);; 江苏省医学科研招标立项课题(H201353);; 镇江市科技支撑社会发展项目(SH2012042&SH2014045)~~