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男性性功能障碍患者性欲低下的影响因素分析

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目的:分析男性性功能障碍患者性欲低下的影响因素,为临床诊治提供依据.方法:回顾性分析2023年6月至2023年9月郑州大学第一附属医院男科门诊111例性功能障碍患者(包括勃起、射精或者性欲障碍),将以性欲低下为主诉或伴随症状的患者分组至性欲低下组(43例),性欲正常组(68例),所有患者均进行国际勃起功能指数问卷表-5(IIEF-5)、早泄诊断量表(PEDT)、男性13项性欲自评量表、健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及血清相关激素检测(FSH、LH、PRL、T、fT、E2、IGF-1、GH),比较两组基本参数差异,并将差异显著的参数与性欲值进行相关性分析.结果:性欲正常组与性欲低下组相比,IIEF-5评分、PEDT评分、性欲评分和IGF-1值显著增高,GAD-7评分明显降低(P<0.05),而PHQ-9评分、FSH、LH、PRL、T、fT、E2、T/E2及 GH 值两组间无显著差异(P>0.05).性欲值与 IIEF-5(r=0.28,P<0.01)、PEDT(r=0.29,P<0.01)、IGF-1(r=0.23,P<0.05)呈正相关,与GAD-7(r=-0.21,P<0.05)呈负相关.结论:性欲低下是多因素导致的结果,生殖激素并不能完全解释性欲的变化.IGF-1水平越低、ED及焦虑程度越重发生性欲低下风险越高.
Factors for low libido in male patients with sexual dysfunction
Objective:To analyze the factors for low libido in male patients with sexual dysfunction and provide some evidence for the clinical diagnosis and treatment of the condition.Methods:We retrospectively analyzed the clinical data on 111 cases of sex-ual dysfunction(including disorders in erection,ejaculation or libido)treated in the Zhengzhou University First Hospital from June to September 2023.According to the patients'complaints of low libido or accompanied symptoms,we divided them into a normal libido group(n=68)and a low libido(n=43),obtained their scores on IIEF-5,Premature Ejaculation Diagnostic Tool(PEDT),13-1-tem Self-Rating Libido Scale for Males(SRLS-M),Patients'Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7),examined the levels of the sexual hormones FSH,LH,PRL,T,free testosterone(fT),E2,?insulin-like growth factor 1(IGF-1)and growth hormone(GH),compared the basic parameters between the two groups,and analyzed their correlation with the libido values.Results:The IIEF-5,PEDT and libido scores and IGF-1 level were significantly higher and the GAD-7 score remark-ably lower in the normal than in the low libido group(P<0.05),but no statistically significant differences were observed between the two groups in the PHQ-9 score and the levels FSH,LH,PRL,T,fT,E2,T/E2 and GH(P>0.05).The libido value was correla-ted positively with the I1EF-5(r=0.28,P<0.01)and PEDT scores(r=0.29,P<0.01)and IGF-1 level(r=0.23,P<0.05),but negatively with the GAD-7 score(r=-0.21,P<0.05).Conclusion:Low libido results from multiple factors,which cannot be fully explained by sexual hormone levels but is closely related to the decreased level of IGF-1 and severity of ED and anxiety.

sexual dysfunctionlow libidoinsulin-like growth factor 1sexual hormonesanxiety

吕秋晨、王瑞、王祖龙、张天标、郑涛、吕坤龙、南永浩

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河南中医药大学第一附属医院男科,河南郑州 450000

郑州大学第一附属医院男科,河南郑州 450000

性功能障碍 性欲低下 胰岛素样生长因子1 生殖激素 焦虑

2024

中华男科学杂志
南京军区南京总医院

中华男科学杂志

CSTPCD
影响因子:1.052
ISSN:1009-3591
年,卷(期):2024.30(8)