Hong Zhiwei, Feng Yuming, Ding Hualong, Hu Xuechun, Lu Jin-Chun, Ge Xie, Ge Yifeng, Yao Bing
Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Laboratory Science, Nanjing Hospital, Jiangsu Corps, The Armed Police Force, PLA, Nanjing, China.
J Sex Med. 2017 Jan;14(1):98-105. doi: 10.1016/j.jsxm.2016.11.002.
Hyperactivity of the sympathetic nervous system can play an important role in lifelong premature ejaculation (PE). Our previous study found that amyloid precursor protein (APP) levels in seminal plasma of patients with PE were clearly increased. Amyloid-β (Aβ) is derived from APP. Excessive Aβ, especially Aβ42, can cause neuronal dysfunction.
To determine whether APP and Aβ42 are associated with an abnormal penile sympathetic skin response (PSSR).
From November 2015 to April 2016, 24 patients with lifelong PE (mean age = 29.2 ± 5.3) with self-estimated intravaginal ejaculatory latency time no longer than 2 minutes and 10 control subjects (mean age = 28.0 ± 5.5) were enrolled consecutively from andrology clinics. PSSR was measured in patients with lifelong PE. APP and Aβ42 levels in seminal plasma were determined.
PSSR in patients with lifelong PE and APP and Aβ42 levels in all subjects.
Patients with PE presented 1.5-fold higher levels of APP (P = .004) than control subjects. Seminal plasma protein concentration (C) in the PE group was lower than that in the control group (P = .007). APP divided by C (APP/C) was 2.0-fold higher (P < .001) in the PE group. Aβ42 level was not different between the PE and control groups, but Aβ42 divided by C (Aβ42/C) was significantly higher in the PE group (P < .001). No differences in APP and APP/C were found between patients with PE in the abnormal and normal PSSR groups. The abnormal PSSR group presented significantly higher Aβ42 (P = .007) and Aβ42/C (P < .001) levels. The latency of PSSR was negatively correlated with Aβ42/C (r = -0.436; P = .033).
These results showed that patients with lifelong PE had higher APP and Aβ42 levels in seminal plasma. Abnormal PSSR was related to a higher Aβ42 level. Drugs that decrease Aβ could be treatment of PE.
交感神经系统功能亢进在终身性早泄（PE）中可能起重要作用。我们之前的研究发现，PE患者精浆中淀粉样前体蛋白（APP）水平明显升高。淀粉样β蛋白（Aβ）由APP衍生而来。过量的Aβ，尤其是Aβ42，可导致神经元功能障碍。
确定APP和Aβ42是否与异常的阴茎交感皮肤反应（PSSR）有关。
2015年11月至2016年4月，从男科门诊连续招募24例终身性PE患者（平均年龄=29.2±5.3岁），其自我估计的阴道内射精潜伏期不超过2分钟，以及10名对照者（平均年龄=28.0±5.5岁）。对终身性PE患者测量PSSR。测定精浆中APP和Aβ42水平。
终身性PE患者的PSSR以及所有受试者的APP和Aβ42水平。
PE患者的APP水平比对照者高1.5倍（P = 0.004）。PE组的精浆蛋白浓度（C）低于对照组（P = 0.007）。PE组中APP除以C（APP/C）高2.0倍（P < 0.001）。PE组和对照组之间的Aβ42水平无差异，但PE组中Aβ42除以C（Aβ42/C）显著更高（P < 0.001）。异常PSSR组和正常PSSR组的PE患者之间在APP和APP/C方面未发现差异。异常PSSR组的Aβ42（P = 0.007）和Aβ42/C（P < 0.001）水平显著更高。PSSR的潜伏期与Aβ42/C呈负相关（r = -0.436；P = 0.033）。
这些结果表明，终身性PE患者的精浆中APP和Aβ42水平较高。异常的PSSR与较高的Aβ42水平有关。降低Aβ的药物可能是治疗PE的方法。
