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年轻心肌梗死幸存者的勃起功能障碍:评估与随访

Erectile Dysfunction in Young Myocardial Infarction Survivors: Evaluation, Follow Up.

作者信息

Dostálová Gabriela, Hlubocká Zuzana, Bayerová Kristýna, Bělohlávek Jan, Linhart Aleš, Karetová Debora

机构信息

1 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.

出版信息

Am J Mens Health. 2017 Nov;11(6):1739-1744. doi: 10.1177/1557988317714359. Epub 2017 Jul 11.

Abstract

Erectile dysfunction significantly affects quality of life in young men. Authors have evaluated erectile function in men with coronary artery disease (CAD) and the relationship between the degree of erectile dysfunction (ED) and the age of their first acute myocardial infarction (AMI). The incidence of erectile dysfunction in three groups of patients of AMI survivors was investigated: AMI survivors younger than 45 years, AMI survivors older than 65 years, and normal male population aged between 30 and 60 years. Erectile function was assessed by the International Index of Erectile Function (IIEF-5) questionnaire. In post-AMI male patients younger than 45 years ( n = 76), mild ED occurred in 26% and severe in 7%. In the older AMI group, mild ED occurred in 52% and severe in 38%. In the control group age matched to younger survivors, 96% denied ED and only one control patient had a score of 20 on the IIEF-5. A paradoxical result was observed in patients using beta blockers (BB), who had better scores than the group without BB. Statin treatment had a positive influence on the score in questionnaires. Those on statins had an average score of 21.0 ± 4.9 vs. without statin 17.7 ± 5.7, p = .03. The current findings identified that the prevalence of ED is relatively high in young patients with CAD and is related to treatment of the CAD. The overall increase in ED presence suggests that the background of their coronary event is not due to destabilization of single focused atheroma but may reflect a generalized atherosclerotic process.

摘要

勃起功能障碍严重影响年轻男性的生活质量。作者评估了冠心病(CAD)男性患者的勃起功能,以及勃起功能障碍(ED)程度与首次急性心肌梗死(AMI)年龄之间的关系。对三组AMI幸存者患者的勃起功能障碍发生率进行了调查:年龄小于45岁的AMI幸存者、年龄大于65岁的AMI幸存者以及年龄在30至60岁之间的正常男性人群。通过国际勃起功能指数(IIEF - 5)问卷评估勃起功能。在年龄小于45岁的AMI男性患者(n = 76)中,轻度ED发生率为26%,重度为7%。在年龄较大的AMI组中,轻度ED发生率为52%,重度为38%。在与年轻幸存者年龄匹配的对照组中,96%的人否认有ED,只有一名对照患者在IIEF - 5上的得分为20。在使用β受体阻滞剂(BB)的患者中观察到一个矛盾的结果,他们的得分比未使用BB的组更好。他汀类药物治疗对问卷得分有积极影响。服用他汀类药物的患者平均得分为21.0±4.9,而未服用他汀类药物的为17.7±5.7,p = 0.03。目前的研究结果表明,CAD年轻患者中ED的患病率相对较高,且与CAD的治疗有关。ED发生率的总体增加表明,他们冠心病事件的背景并非单一局限性动脉粥样硬化斑块不稳定所致,而可能反映了一种全身性动脉粥样硬化过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d06/5675271/5eaa7394e6b0/10.1177_1557988317714359-fig1.jpg

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