Tian Ye, Ji Zheng-guo, Tang Ya-wang, Zhang Lei, Lü Wen-cheng, Lin Jun, Guo Hong-bo, Xie Ze-lin, Sun Wen, Du Lin-dong, Ao Jian-Hua, Ma Lin-Lin, Chen Li-Sheng, Xu Yuan-Cheng
Depatment of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Chin Med J (Engl). 2008 May 5;121(9):795-9.
Renal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs).
A cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months.
Complaints of ED were reported by 75.5% of the 809 RTRs (age range 19 - 75 years, mean age (45 +/- 10) years), whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%, respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P = 0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%, 75.2%, 87.5% and 92.2% in patients with age below 30 years, 31 - 40 years, 41 - 50 years, 51 - 60 years and over 60 years, respectively (P = 0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P = 0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P = 0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P = 0.000). Patients, whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P = 0.000, 0.001, 0.000, 0.000, respectively). After Logistic regression analysis, only five factors, age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life and CsA-based immunosuppressive regimens sustained their significance.
Renal transplant has varying effects on erectile function. ED is highly prevalent among RTRs and its influential factors are multiple. Age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life, CsA-based immunosuppressive regimens are the main influential factors of ED in male RTRs.
肾移植可改善受者生活质量，但性生活质量可能未得到改善。本研究旨在调查男性肾移植受者（RTRs）勃起功能障碍（ED）的患病率及其影响因素。
在三个肾移植中心进行横断面调查。由经过培训的访谈员向824名过去6个月有活跃性生活的男性肾移植患者发放结构化问卷。
809名完成问卷的RTRs（年龄范围19 - 75岁，平均年龄（45±10）岁）中，75.5%报告有ED主诉。轻度、中度和重度ED的报告率分别为53.6%、8.3%和13.6%。与性功能正常的移植受者相比，有ED的男性RTRs的平均年龄和移植时间显著更高（分别为P = 0.00和0.04）。ED患病率随年龄增长而增加。年龄低于30岁、31 - 40岁、41 - 50岁、51 - 60岁和60岁以上患者的ED患病率分别为60.7%、65.8%、75.2%、87.5%和92.2%（P = 0.000）。此外，ED严重程度随年龄增长而增加。40岁以下患者中重度ED的比例从6.7%增加到40岁以上患者中的28.9%（P = 0.000）。无业的RTRs中ED患病率高于有工作的RTRs（P = 0.001）。ED患病率随教育水平提高而降低。小学及以下、初中、高中、大专及以上学历男性的ED患病率分别为94.3%、86.4%、74.0%和67.8%（P = 0.000）。髂内动脉远端中断并接受多次移植、担心性生活影响移植肾功能且接受基于环孢素（CsA）的免疫抑制方案的患者更易发生ED（分别为P = 0.000、0.001、0.000、0.000）。经Logistic回归分析后，只有年龄、教育水平、髂内动脉远端中断、担心性生活影响移植肾功能和基于CsA的免疫抑制方案这五个因素仍具有统计学意义。
肾移植对勃起功能有不同影响。ED在RTRs中高度流行，其影响因素是多方面的。年龄、教育水平、髂内动脉远端中断、担心性生活影响移植肾功能、基于CsA的免疫抑制方案是男性RTRs中ED的主要影响因素。
