Department of Rheumatology, Basel University, Burgfelderstrasse 101, CH 4012 Basel, Switzerland.
Rheumatology (Oxford). 2014 Apr;53(4):639-43. doi: 10.1093/rheumatology/ket392. Epub 2013 Dec 5.
The objective of this study was to analyse an association between nailfold capillary abnormalities and the presence and severity of erectile dysfunction (ED) in men with SSc.
A cross-sectional analysis of the prospective European League Against Rheumatism (EULAR) Scleroderma Trial and Research database was performed. Men with SSc were included if they had undergone nailfold capillaroscopy and simultaneous ED assessment with the 5-item International Index for Erectile Function (IIEF-5).
Eighty-six men met the inclusion criteria. Eight men (9.3%) had not had sexual intercourse and could not be assigned an IIEF-5 score. Sixty-nine of the 78 men (88.5%) with an IIEF-5 score had nailfold capillary abnormalities, of whom 54 (78.3%) suffered from ED. Nine men (11.5%) had no nailfold capillary abnormalities, of whom six (66.7%) had ED (P = 0.44). ED was more frequent in older men (P = 0.002) and in men with diffuse disease (P = 0.06). Men with abnormal capillaroscopy had a higher median EULAR disease activity than men without (P = 0.02), a lower diffusing capacity of the lung (P = 0.001) and a higher modified Rodnan skin score (P = 0.04), but mean IIEF-5 scores did not differ [15.7 (S.D. 6.2) vs 15.7 (S.D. 6.3)]. IIEF-5 scores did not differ between men with early (n = 12), active (n = 27) or late (n = 27) patterns (IIEF-5 scores of 17.9, 16.3 and 14.7, respectively). There were no differences in the prevalence of early, active and late capillaroscopy patterns between men with or without ED.
Neither the presence or absence of abnormal capillaroscopy findings nor the subdivision into early, active and late patterns is associated with coexistent ED in SSc.
本研究旨在分析甲襞毛细血管异常与系统性硬化症(SSc)男性患者存在和严重程度的勃起功能障碍(ED)之间的关系。
对前瞻性欧洲抗风湿病联盟(EULAR)硬皮病试验和研究数据库进行了横断面分析。纳入了接受过甲襞毛细血管显微镜检查和同时进行 5 项国际勃起功能指数(IIEF-5)评估的 SSc 男性患者。
86 名男性符合纳入标准。8 名男性(9.3%)未发生过性行为,无法分配 IIEF-5 评分。78 名 IIEF-5 评分有甲襞毛细血管异常的男性中,有 69 名(88.5%)患有 ED。9 名男性(11.5%)无甲襞毛细血管异常,其中 6 名(66.7%)患有 ED(P=0.44)。ED 在年龄较大的男性中更为常见(P=0.002),在弥漫性疾病的男性中更为常见(P=0.06)。毛细血管镜检查异常的男性的 EULAR 疾病活动中位数高于无异常的男性(P=0.02),弥散能力更低(P=0.001),改良 Rodnan 皮肤评分更高(P=0.04),但平均 IIEF-5 评分无差异[15.7(标准差 6.2)比 15.7(标准差 6.3)]。早期(n=12)、活动期(n=27)或晚期(n=27)模式的男性 IIEF-5 评分分别为 17.9、16.3 和 14.7,评分之间无差异。有或无 ED 的男性中,早期、活动期和晚期毛细血管镜检查模式的患病率无差异。
无论甲襞毛细血管镜检查有无异常发现,还是将其细分为早期、活动期和晚期模式,均与 SSc 并存的 ED 无关。