Erectile dysfunction and associated risk factors in male patients with ischemic stroke A cross-sectional study
Erectile dysfunction and associated risk factors in male patients with ischemic stroke A cross-sectional study
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DOI：
10.1097/md.0000000000018583
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发表时间：
2020-01-01
期刊：
影响因子：
1.6
通讯作者：
Wang, Bin
中科院分区：
文献类型：
--
作者：
Dai, Hengheng;Wang, Jisheng;Wang, Bin
缺血性脑卒中（ischemic stroke，IS）患者常伴有勃起功能障碍（erectile dysfunction，艾德）和心理障碍。但由于这些症状在脑卒中恢复期更为明显，影响了患者的性生活质量，往往被忽视。本研究旨在调查脑卒中患者艾德的发生率、性生活质量和心理状态，并分析影响其心理状态的相关危险因素。共入组361例IS患者。采用国际勃起功能指数-5量表诊断ED，并将患者分为艾德组和非艾德组。磁共振成像用于评估患者的脑部病变。采用美国国立卫生研究院卒中量表（NationalInstitutesofHealth Stroke Scale，NHST）评定神经功能缺损程度，采用患者健康问卷（PHQ-9）和广泛性焦虑障碍（GAD-7）评定抑郁和焦虑。比较艾德组与非艾德组临床因素的差异。有效率为88.6%（n = 320），超过三分之二的患者报告了艾德（77.8%）。艾德患者的PHQ-9水平较高（8.40 +/- 4.18 vs 4.94 +/- 3.73，P < .01）和GAD-7（6.73 +/- 3.56 vs 4.51 +/- 3.35，P < .01）得分，更可能有额叶（75.1%比49.3%，P < .01）和侧脑室（69.8% vs 53.5%，P = .01）病变，伴高血压高脂血症组（48.2%vs25.4%）、降压药组（67.9%vs35.25，P <0.01）、降脂药组（43.4%vs16.9%，P <0.01）。多因素Logistic回归分析显示，降压药（比值比[OR]：2.50，95%置信区间[CI]：1.02-6.10，P = .04），抑郁症（OR：1.18，95%CI：1.06-1.32，P < .01）和焦虑（OR：1.13，95%CI：1.01-1.27，P = .04）可能是艾德组的独立危险因素。艾德多见于男性IS患者。抗高血压药物、抑郁、焦虑是影响ED的主要因素。
Patients with ischemic stroke (IS) often suffered from the problem of erectile dysfunction (ED) and psychological disease. However, they are often ignored because these symptoms are more obvious in the convalescent stage of stroke, which affects the quality of sexual life of patients. This study aimed to investigate the incidence of ED, sexual quality of life, and mental state of patients after stroke, as well as analyze the relevant risk factors affecting their psychological status. A total of 361 IS patients were enrolled. The international erectile function index-5 scale was used to diagnose ED. Accordingly, the patients were divided into ED group and non-ED group. Magnetic resonance imaging was used to evaluate the brain lesions of patients. We assessed neurological deficits by the National Institutes of Health Stroke Scale score and patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) were used to evaluate the depression and anxiety. The differences between the ED group and the non-ED group clinical factors were compared. The response rate was 88.6% (n = 320), and more than two-thirds of patients reported ED (77.8%). Patients with ED had higher PHQ-9 (8.40 +/- 4.18 vs 4.94 +/- 3.73, P < .01) and GAD-7 (6.73 +/- 3.56 vs 4.51 +/- 3.35, P < .01) scores, were more likely to have the frontal lobe (75.1% vs 49.3%, P < .01) and lateral ventricle (69.8% vs 53.5%, P = .01) lesions, with hypertension (75.1% vs 46.5%, P < .01) and hyperlipidemia (48.2% vs 25.4%), and on antihypertensive (67.9% vs 35.25, P < .01) and hypolipidemic drug (43.4% vs 16.9%, P < .01). Multivariate logistic regression analysis showed that antihypertensive drug (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.02-6.10, P = .04), depression (OR: 1.18, 95% CI: 1.06-1.32, P < .01) and anxiety (OR: 1.13, 95% CI: 1.01-1.27, P = .04) might be the independent risk factors for ED group. ED is more common in male IS patients. Antihypertensive drug, depression and anxiety are the main factors affecting ED.