Sexual dysfunction in uremia.
Sexual dysfunction in uremia.
复制标题
尿毒症性功能障碍。
DOI：
--
复制
发表时间：
1999
影响因子：
13.6
通讯作者：
B. Palmer
中科院分区：
文献类型：
--
作者：
B. Palmer
总之，性功能障碍是慢性肾功能衰竭男性和女性的常见症状。常见的障碍包括男性勃起功能障碍、女性月经异常以及两性性欲和生育能力下降。这些异常主要是器质性的，与尿毒症以及慢性肾功能衰竭患者经常伴随的其他合并症有关。与慢性疾病的存在相关的疲劳和心理社会因素也是促成因素。下丘脑-垂体-性腺轴的紊乱可以在需要透析之前检测到，但一旦开始透析治疗就会继续恶化。尿毒症男性的性腺功能受损很明显，而下丘脑垂体轴的紊乱则更为微妙。相比之下，尿毒症女性的中枢紊乱更为突出。治疗最初的目的是优化透析的实施、用重组促红细胞生成素纠正贫血，以及用维生素 D 控制继发性甲状旁腺功能亢进的程度。对于许多执业肾科医生来说，西地那非已成为治疗阳痿的一线疗法。对于性腺机能减退的男性来说，唯一的主诉是性欲下降，睾酮可能会有所帮助。尿毒症女性需要定期进行妇科随访，以预防雌激素作用不受对抗的潜在并发症。应建议尿毒症女性在透析期间不要怀孕。成功的移植是慢性肾衰竭男性和女性恢复正常性功能的最有效方法。
In summary, sexual dysfunction is a common finding in both men and women with chronic renal failure. Common disturbances include erectile dysfunction in men, menstrual abnormalities in women, and decreased libido and fertility in both sexes. These abnormalities are primarily organic in nature and are related to uremia as well as the other comorbid conditions that frequently accompany the chronic renal failure patient. Fatigue and psychosocial factors related to the presence of a chronic disease are also contributory factors. Disturbances in the hypothalamic-pituitary-gonadal axis can be detected before the need for dialysis but continue to worsen once dialytic therapy is initiated. Impaired gonadal function is prominent in uremic men, whereas the disturbances in the hypothalamicpituitary axis are more subtle. By contrast, central disturbances are more prominent in uremic women. Therapy is initially directed toward optimizing the delivery of dialysis, correcting anemia with recombinant erythropoietin, and controlling the degree of secondary hyperparathyroidism with vitamin D. For many practicing nephrologists, sildenafil has become the first-line therapy in the treatment of impotence. In the hypogonadal man whose only complaint is decreased libido, testosterone may be of benefit. Regular gynecologic follow-up is required in uremic women to guard against potential complications of unopposed estrogen effect. Uremic women should be advised against pregnancy while on dialysis. Successful transplantation is the most effective means of restoring normal sexual function in both men and women with chronic renal failure.
患有慢性肾功能衰竭的青春期患者的免疫反应性和生物活性黄体生成激素。
影响因子：
19.6
作者：
Schaefer,F;Veldhuis,JD;Robertson,WR;Dunger,D;Schärer,K
通讯作者：
Schärer,K