目的：探讨慢性肾衰竭男性患者血液透析后性功能障碍（ ED）的影响因素。方法选取2002年2月-2011年10月在潍坊医学院附属益都中心医院和青州市人民医院血液透析中心进行维持性血液透析的慢性肾衰竭男性患者共164例，根据有无性行为将患者分为A组（62例，有性行为）和B组（102例，无性行为）。采用勃起功能国际指数（IIEF-5）问卷、Beck抑郁自评问卷（BDI）及健康状况调查问卷（SF-36），分别对患者的性功能、心理抑郁情况及生活质量进行调查，比较两组患者的临床资料及问卷调查结果，采用二项分类变量Logistic回归分析ED的影响因素。结果两组患者的年龄，透析前血肌酐、血钙、血磷水平，尿素清除指数（ spKt/V），血浆全段甲状旁腺素（iPTH）水平间有差异（P<0.05）。A组患者ED及抑郁程度较B组轻（P<0.05）。A组患者躯体疼痛（BP）、精力/疲乏（ VT/FG）、情感问题所导致的角色限制（ REP）得分及SF-36总分高于B组，而情感健康（ EH）得分低于B组（P<0.05）。Logistic回归分析显示，年龄、BDI得分、糖尿病与患者勃起功能、性交满意度、性高潮及性功能总得分存在回归关系（P<0.05）；BDI得分及血肌酐、血钙、血尿素氮水平与综合满意度存在回归关系（P<0.05）。结论年龄增加、抑郁、糖尿病是慢性肾衰竭男性患者血液透析后性功能障碍的危险因素。%Objective Toexploretheinfluencingfactorsforsexualdysfunctioninpatientswithchronicrenalfailureaf-terhemodialysis.Methods Atotalof164patientswithchronicrenalfailurewhoreceivedmaintenancehemodialysisinhemodial-ysis center of Yidu Central Hospital Affiliated to Weifang Medical College and Qingzhou People's Hospital from February 2002 to October 2011 were selected as study subjects,according to the presence of sexual behavior,the patients were divided into group A(62 cases,sexual behavior exists)and group B(102 cases,sexual behavior does not exist). Sexual function,depression and life quality of patients were investigated by using International Index of Erectile Function(IIEF-5),Beck depression self-reported questionnaire(BDI)and Health questionnaire(SF-36). The clinical data and the result of questionnaire survey were compared between two groups of patients,the influence factors for ED was assessed by using binomial Logistic regression analy-sis.Results Thereweresignificantdifferencesinage,serumcreatininebeforethedialysis,calciumlevel,phosphoruslevel, urea clearance index(spKt/V)and plasma iPTH level between two groups of patients(P<0. 05). The degree of ED and de-pression in group A were significantly lower than those in group B(P <0. 05);The scores of BP,VT/FG,REP and total scores of SF-36 in group A were significantly higher than those in group B,EH score in group A was significantly lower than that in group B(P<0. 05). According to results of Logistic regression analysis,there were remarkable regression relationships be-tween age,diabetes,BDI scores and erectile function,intercourse satisfaction,total scores of sexual orgasm and sexual function (P<0. 05). There were remarkable regression relationships between BDI score,serum levels of creatinine,calcium,urea ni-trogenandcomprehensivedegreeofsatisfaction(P<0.05).℅onclusion Olderage,depressionanddiabeteswereriskfactors for sexual dysfunction in patients with chronic renal failure after hemodialysis.
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