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[植入式心脏复律除颤器(ICD)男性受者的性功能障碍、抑郁与生活质量——有或无电击治疗]

[Sexual dysfunction, depression and quality of life in male implantable cardioverter defibrillator (ICD) recipients--with and without shock delivery].

作者信息

Shiyovich Arthur, Ben Zion Izhak Z, Plakht Ygal, Amit Guy, Grosbard Aviva, Katz Amos

机构信息

Faculty of Health Sciences, Ben-Gurion University, Beer Sheba.

出版信息

Harefuah. 2007 Aug;146(8):594-8, 647.

PMID:17853553
Abstract

BACKGROUND AND OBJECTIVES

Sexual concerns are prevalent among ICD recipients. Our goal was to evaluate the prevalence of sexual dysfunction (SD), depression, and quality of life (QOL) in male recipients of ICD with and without shock delivery.

PATIENTS AND METHODS

ICD implanted males were asked to fill-out 3 self-administered questionnaires: Florida Patient Acceptance Survey (FPAS), Centre for Epidemiologic Studies Depression Scale (CES-D), and Arizona Sexual Experiences Scale (ASES). All patients were offered a referral to a sex clinic.

RESULTS

A total of 47/72 patients (65%), agreed to participate. Patients were classified into no-shock [NS] (66%) and at least one shock [S] (34%) groups. SD defined as worse than median ASES male score was found in 42.6% of the patients, 52% and 25% in NS/S groups, respectively (p = 0.08). ICD related deterioration in sexual function (SF) was reported by 71% vs. 44% of NS/S groups, respectively (p = 0.069), and by 85% of the patients with SD vs. 44.4% of the better SF group (p = 0.005). Twenty three (49%) patients were referred to a sex clinic. Depression (CES-D score= 16) was found in 36% of the study group. CES-D score mean ranks were 21 vs. 30 in the NS/S groups respectively, (p = 0.049). QOL was similar in NS/S groups. No correlation was found between SD and depression or QOL, however, depression correlates with low QOL (Pearson correlation = 0.416, p = 0.04).

CONCLUSIONS

ICD implantation seems to impair male SF. Receiving a shock might be associated with a protective effect on SF. ICD implanted males are at risk for depression S > NS. QOL was similar in NS/S groups. ICD implanted males should be screened and treated for SD and depression.

摘要

背景与目的

性问题在植入式心律转复除颤器(ICD)接受者中普遍存在。我们的目标是评估有或无电击治疗的男性ICD接受者性功能障碍(SD)、抑郁及生活质量(QOL)的患病率。

患者与方法

植入ICD的男性被要求填写3份自行管理的问卷:佛罗里达患者接受度调查(FPAS)、流行病学研究中心抑郁量表(CES-D)及亚利桑那性体验量表(ASES)。所有患者均被转介至性诊所。

结果

共有47/72名患者(65%)同意参与。患者被分为无电击[NS]组(66%)和至少接受过一次电击[S]组(34%)。定义为ASES男性评分低于中位数的SD在42.6%的患者中被发现,NS/S组分别为52%和25%(p = 0.08)。分别有71%和44%的NS/S组报告性功能(SF)出现与ICD相关的恶化(p = 0.069),SD患者中有85%,而SF较好组为44.4%(p = 0.005)。23名(49%)患者被转介至性诊所。研究组中36%的患者存在抑郁(CES-D评分 = 16)。CES-D评分平均秩次在NS/S组分别为21和30(p = 0.049)。NS/S组的生活质量相似。未发现SD与抑郁或生活质量之间存在相关性,然而,抑郁与低生活质量相关(Pearson相关性 = 0.416,p = 0.04)。

结论

ICD植入似乎会损害男性性功能。接受电击可能对性功能有保护作用。植入ICD的男性有抑郁风险,S组 > NS组。NS/S组的生活质量相似。应对植入ICD的男性进行性功能障碍和抑郁的筛查及治疗。

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