Zifroni A, Schiavi R C, Schaffner F
Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029.
Hepatology. 1991 Sep;14(3):479-82.
The effects of nonalcoholic liver disease on sexual desire, arousal, activity, orgasmic function and satisfaction and serum testosterone levels were studied in 75 men with nonalcoholic liver disease. Each man was interviewed about his sexual behavior and problems and was asked to comment on whether he felt liver disease affected his sexual function. The average age of the patients was 49 yr, and a wide variety of liver diseases was represented. Child-Pugh grading was A in 51 patients, B in 18 and C in 6; the mean duration of liver disease was 8 yr. Sexual desire, arousal and activity of patients with grade A disease were within the ranges observed in studies of healthy men of comparable age. Diminished sexual desire was reported by 2% of grade A patients and 35% of grade B and C patients (p less than 0.005). Arousal problems were noted by 16% of grade A patients, 60% of grade B patients and 67% of C patients (p less than 0.005). Loss of erection and inability to regain erection were noted by 7%, 40% and 67% of grade A, B and C patients, respectively (p less than 0.01). Premature and retarded ejaculation were more frequent in patients classed in Child-Pugh grades B and C. Frequency of coitus and orgasm were significantly higher in grade A patients than in grade B and C patients. Total and free testosterone levels were (in nanograms per milliliter) A, 677/1.78; B, 416/1.06; and C, 178/0.43 (p less than 0.002). We concluded that Child-Pugh grade A nonalcoholic liver disease in men does not affect sexual desire, function or performance. Men with disease grades B and C have significant sexual dysfunction and significant reduction of both total and free testosterone levels.
对75名非酒精性肝病男性患者研究了非酒精性肝病对性欲、性唤起、性行为、性高潮功能及满意度以及血清睾酮水平的影响。每位男性均接受了关于其性行为及问题的访谈，并被问及是否觉得肝病影响了他的性功能。患者的平均年龄为49岁，涵盖了多种肝病类型。Child-Pugh分级中，51例为A级，18例为B级，6例为C级；肝病的平均病程为8年。A级肝病患者的性欲、性唤起及性行为处于年龄相仿的健康男性研究中观察到的范围内。2%的A级患者报告性欲减退，B级和C级患者中该比例为35%（p<0.005）。16%的A级患者、60%的B级患者及67%的C级患者存在性唤起问题（p<0.005）。A级、B级和C级患者中阴茎勃起丧失及无法恢复勃起的比例分别为7%、40%和67%（p<0.01）。早泄和射精延迟在Child-Pugh分级为B级和C级的患者中更为常见。A级患者的性交频率和性高潮频率显著高于B级和C级患者。总睾酮水平和游离睾酮水平（以纳克/毫升计）分别为：A级，677/1.78；B级，416/1.06；C级，178/0.43（p<0.002）。我们得出结论，男性Child-Pugh A级非酒精性肝病不影响性欲、功能或表现。B级和C级肝病男性存在显著的性功能障碍，总睾酮水平和游离睾酮水平均显著降低。
