McGill University and Jewish General Hospital, Montreal, Quebec, Canada.
Arthritis Care Res (Hoboken). 2012 Mar;64(3):340-50. doi: 10.1002/acr.20696.
To assess 1) the rates of sexual activity and impairment, 2) clinical correlates of sexual activity/impairment, and 3) common sources of pain during and after sex in a large sample of female patients with systemic sclerosis (SSc; scleroderma).
We performed a cross-sectional multicenter study of female SSc patients from the Canadian Scleroderma Research Group Registry. Patients underwent medical examinations and clinical histories and were asked whether they had engaged in sexual activities with their partner in the past 4 weeks. Sexually active patients completed a 9-item version of the Female Sexual Function Index (FSFI) and items related to problems that may be linked to sexual dysfunction in SSc. Multivariate logistic regressions assessed independent predictors of activity/inactivity and sexual dysfunction.
A total of 226 (41%) of 547 patients, including 215 (54%) of the 401 patients currently in relationships, reported having engaged in sexual activities with a partner in the past 4 weeks. Among 165 sexually active patients with complete data for all variables, 102 (62%) had FSFI total scores ≤22.5, indicating impaired function. Seventeen percent of the patients were sexually active and not impaired. Independent predictors (P < 0.05) of sexual activity were younger age, fewer gastrointestinal symptoms, and less severe Raynaud's phenomenon symptoms. Sexual impairment was independently associated with older age, higher skin scores, and more severe breathing problems. Vaginal pain was 8 times more likely among women with impairment.
Research is needed to compare the extent of activity and impairment in SSc compared to women without SSc and to develop interventions to address impaired sexual function in women with SSc.
评估 1）性行为和障碍的发生率，2）性行为/障碍的临床相关性，以及 3）在一个大型系统性硬化症（SSc；硬皮病）女性患者样本中，性活动期间和之后常见的疼痛来源。
我们对来自加拿大硬皮病研究组登记处的女性 SSc 患者进行了一项横断面多中心研究。患者接受了体格检查和临床病史检查，并被问及他们在过去 4 周内是否与伴侣进行了性行为。有性行为的患者完成了女性性功能指数（FSFI）的 9 项版本和与 SSc 中可能与性功能障碍相关的问题相关的项目。多变量逻辑回归评估了活动/不活动和性功能障碍的独立预测因素。
共有 547 名患者中的 226 名（41%），包括 401 名目前有伴侣的患者中的 215 名（54%），报告在过去 4 周内与伴侣进行了性行为。在 165 名有完整数据的有性行为的患者中，102 名（62%）的 FSFI 总分为≤22.5，表明功能受损。17%的患者有性行为但没有受损。性行为的独立预测因素（P<0.05）为年龄较小、胃肠道症状较少和雷诺现象症状较轻。性障碍与年龄较大、皮肤评分较高和呼吸问题较严重独立相关。有障碍的女性发生阴道疼痛的可能性是没有障碍的女性的 8 倍。
需要进行研究比较 SSc 女性与无 SSc 女性的活动和障碍程度，并开发干预措施来解决 SSc 女性的性功能障碍。
