Lai Chun-Fu, Wang Yu-Ting, Hung Kuan-Yu, Peng Yu-Sen, Lien Yih-Ron, Wu Ming-Shiou, Chang Chung-Hsin, Chiang Shou-Shang, Yang Chwei-Shiun, Shiah Ching-Jyh, Lu Chia-Sheng, Yang Chih-Ching, Chuang Hsueh-Fang, Wu Kwan-Dun, Tsai Tun-Jun, Chen Wang-Yu
Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
Am J Nephrol. 2007;27(6):615-21. doi: 10.1159/000108357. Epub 2007 Sep 11.
BACKGROUND/AIMS: Sexual dysfunction in patients undergoing peritoneal dialysis (PD) is highly prevalent, but studies addressing this issue are scarce. This cross-sectional study aims to evaluate sexual dysfunction and the determinants among PD patients.
All chronic PD patients in 8 PD centers were asked to complete a self-reported questionnaire - the International Index of Erectile Function (IIEF) for men and the Index of Female Sexual Function (IFSF) for women - so that sexual function could be assessed. They also answered the Beck Depression Inventory (BDI) to measure depressive symptoms.
Among 294 patients invited for study, 54 men (mean age 48.8 +/- 10.8 years) and 45 women (mean age 43.6 +/- 7.4 years) were willing to and completed the sexual function questionnaires. The median IIEF score in the men was 56.25. The prevalence of erectile dysfunction, identified by the score in erectile domain of IIEF <or=25, was 51.9%. Older age and higher fasting glucose levels were independently associated with a decreased IIEF score. In women, IFSF score (with a median 27) was significant lower than in healthy peri- or postmenopausal control women. Factors of higher BDI score, receiving automated PD, and older age independently associated with a decreased IFSF score.
Sexual dysfunction is clinically relevant and multi-dimensional among PD patients. Gender differences exist in the attributing factors of sexual functioning. These warrant more awareness and investigation in the global health care of dialysis patients.
背景/目的:腹膜透析(PD)患者性功能障碍非常普遍,但针对此问题的研究较少。本横断面研究旨在评估PD患者的性功能障碍及其决定因素。
邀请8个PD中心的所有慢性PD患者完成一份自我报告问卷——男性用国际勃起功能指数(IIEF),女性用女性性功能指数(IFSF),以便评估性功能。他们还回答了贝克抑郁量表(BDI)以测量抑郁症状。
在受邀参加研究的294例患者中,54例男性(平均年龄48.8±10.8岁)和45例女性(平均年龄43.6±7.4岁)愿意并完成了性功能问卷。男性IIEF评分中位数为56.25。根据IIEF勃起功能领域评分≤25确定的勃起功能障碍患病率为51.9%。年龄较大和空腹血糖水平较高与IIEF评分降低独立相关。在女性中,IFSF评分(中位数为27)显著低于健康的围绝经期或绝经后对照女性。BDI评分较高、接受自动化腹膜透析和年龄较大的因素与IFSF评分降低独立相关。
性功能障碍在PD患者中具有临床相关性且是多维度的。性功能的归因因素存在性别差异。这些情况需要在透析患者的全球医疗保健中得到更多关注和研究。