摘要
目的 对男性勃起功能障碍(ED)患者进行心理量表评估及血清总睾酮值(TT)检测,分析心理因素及内分泌因素对不同年龄段ED患者的影响.方法 选取2018年9月至2021年9月江苏省中医院男科诊治的1 411例ED患者作为研究对象.对其进行90项症状自评量表(SCL-90)心理测评,以及状态特质焦虑量表、国际勃起功能指数问卷表(IIEF)调查,并抽血检测血清TT.根据患者年龄将其分为三组(A组:20～30岁;B组:＞30～40岁;C组:＞40～50岁),另外根据IIEF结果将各年龄组患者分为轻度(12～21分)、中度(8～11分)、重度(≤7分),对各组间TT、心理测评结果进行比较.结果 B组、C组TT较A组显著下降(P＜0.05);B组与C组TT比较,差异无统计学意义(P＞0.05).A组内不同严重程度ED患者TT比较,差异无统计学意义(P＞0.05);B组内轻度ED患者TT显著高于重度患者(P＜0.05);C组内轻度、中度ED患者TT显著高于重度患者(P＜0.05).与A组、B组相比,C组抑郁、强迫、恐怖、精神病性、人际关系、SCL-90和状态特质焦虑量表评分显著降低(P＜0.05).A组内不同严重程度ED患者SCL-90、状态特质焦虑量表评分比较,差异无统计学意义(P＞0.05);B组内,中度、重度ED患者间SCL-90、状态特质焦虑量表评分比较,差异无统计学意义(P＞0.05),轻度ED患者的敌对、焦虑、恐怖、偏执、精神病性、强迫症状、抑郁因子分、SCL-90总分和状态特质焦虑量表评分显著低于中度、重度ED患者(P＜0.05);C组内,轻度、中度ED患者间SCL-90、状态特质焦虑量表评分比较,差异无统计学意义(P＞0.05),轻度ED患者的焦虑、其他和状态焦虑等评分显著低于重度ED患者(P＜0.05),中度ED患者的人际关系、抑郁、SCL-90总分显著低于重度患者(P＜0.05).结论 TT及心理因素对不同年龄段ED患者有不同程度的影响.相较于年轻ED患者,TT对高龄ED患者有着更显著的影响.相较于高龄ED患者,心理因素对年轻ED患者有着更显著的影响,年轻ED患者表现出更严重的焦虑、抑郁情绪.
Abstract
Objective To perform psychological scale assessment and serum total testosterone(TT)in male patients with erectile dysfunction(ED),and analyze the effects of psychological factors and endocrine factors on ED patients of different ages.Methods A total of 1,411 ED patients admitted to Department of Andrology,Jiangsu Province Hospital of Chinese Medicine from September 2018 to September 2021 were selected as study objects.They were investigated by symptom checklist 90(SCL-90),state-trait anxiety inventory(STAI),and international index of erectile function(IIEF).And serum TT was detected by blood sampling.Patients were divided into three groups(group A:20-30 years old,group B:＞30-40 years old,group C:＞40-50 years old)according to age.In addition,patients in each group were divided including mild(12-21 points),moderate(8-11 points),and severe(≤7 points)according to IIEF scores.The level of TT and psychological assessment results were compared between groups.Results The TT levels of group B and C were significantly decreased than that of group A(P＜0.05),and there were no significant differences between group B and C(P＞0.05).There was no significant difference in TT among ED patients with different severity in group A(P＞0.05).The TT level of mild ED patients was significantly higher than that of severe ED patients in group B(P＜0.05).The TT level of mild and moderate ED patients was significantly higher than that of severe ED patients in group C(P＜0.05).The scores of depression,obsession,phobia,psychoticism,interpersonal relationship,SCL-90 and STAI of group C were significantly lower than those of group A and B(P＜0.05).There were no significant differences in SCL-90 and STAI scores among ED patients with different severity of group A(P＞0.05).There were no significant differences in SCL-90 and STAI scores among moderate and severe ED patients of group B(P＞0.05),and the factor scores of hostility,anxiety,phobia,paranoid,psychoticism,obsession,depression and total scores of SCL-90 and STAI in mild ED patients were significantly lower than those of moderate and severe ED patients in group B(P＜0.05).There were no significant differences in SCL-90 and STAI scores of mild and moderate ED patients in group C(P＞0.05),and the scores of anxiety,other and state anxiety of mild ED patients were significantly lower than those of severe ED patients(P＜0.05),and the scores of interpersonal relationship,depression and total scores of SCL-90 of mild ED patients were significantly lower than those of severe ED patients(P＜0.05).Conclusions Serum TT and psychological factors have different degrees of influences on ED patients with different ages.Compared with younger patients,serum TT has more significant effects on elderly patients with ED.Compared with elderly patients,psychological factors have more significant effects on young patients with ED,and young ED patients show more severe anxiety and depression.
基金项目
江苏省卫生健康委重点项目(ZDA2020025)
南京中医药大学自然科学研究项目(XZR2020003)
江苏省中医药科技发展计划面上项目(MS2022023)
江苏省中医院优秀青年博士培养计划(2023QB0126)
江苏省中医院院级创新发展基金专项(Y2021CX24)
江苏省中医院院内课题(Y21008)
江苏省中医院院内课题(Y22029)
江苏省研究生科研与实践创新计划校助面上项目()
维普
万方数据