Cardiovascular Physiology and Responses to Sexual Activity in Individuals Living with Spinal Cord Injury.
Cardiovascular Physiology and Responses to Sexual Activity in Individuals Living with Spinal Cord Injury.
复制标题
脊髓损伤患者的心血管生理学和对性活动的反应。
DOI：
10.1310/sci2301-11
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发表时间：
2017
影响因子：
2.9
通讯作者：
A. Phillips
中科院分区：
文献类型：
--
作者：
R. Davidson;A. Phillips
背景：脊髓损伤(SCI)可严重影响自主神经功能，导致不同程度的心血管、支气管肺、出汗、膀胱、肠道和性功能障碍。心血管系统对性功能至关重要，因为它负责在性行为期间血液流向海绵状组织和肌肉骨骼组织。脊髓损伤后易出现静息低血压(LRBP)、立位性低血压(OH)和自主神经反射障碍(AD)3种主要异常，所有这些都对性功能有重要影响。方法：我们回顾了目前脊髓损伤后心血管功能障碍的病因学机制和表现，并讨论了其如何影响脊髓损伤患者的性功能。结论：所有脊髓损伤达到或超过T6神经水平的个体在性刺激过程中患AD的风险增加，且与更高的损伤水平和更大的损伤完整性相关。AD可以沉默，患有脊髓损伤的人应该意识到基线和性行为期间的血压值。实施振动刺激生育程序的临床医生需要意识到AD的风险，并考虑在必要时进行预处理。研究性刺激对心血管反应的研究人员应该考虑持续监测血压，因为间歇性监测可能会低估真实的血压值。
Background: Spinal cord injury (SCI) may profoundly impact autonomic function producing a variable degree of dysfunction in cardiovascular, bronchopulmonary, sweating, bladder, bowel, and sexual function. The cardiovascular system is crucially important for sexual function, as it is responsible for blood flow shifts to cavernous and musculoskeletal tissue during sexual activity. This system is prone to 3 main abnormalities after SCI including low resting blood pressure (LRBP), orthostatic hypotension (OH), and autonomic dysreflexia (AD), all of which have important effects on sexual function. Methods: We review the current etiological mechanisms and manifestations of cardiovascular dysfunction after SCI and discuss how this is documented to impact sexual function in individuals living with SCI. Conclusions: All individuals with SCI at or above the T6 neurologic level have an increased risk of AD during sexual stimulation, with increasing risk associated with higher levels of injury and greater completeness of injury. AD can be silent, and individuals living with SCI should be aware of blood pressure values at baseline and during sexual activity. Clinicians performing vibrostimulation fertility procedures need to be aware of the risk of AD and consider pretreatment if needed. Researchers studying the cardiovascular response to sexual stimulation should consider continuous monitoring of blood pressure, as intermittent monitoring may underestimate true blood pressure values.