Lugoboni Fabio, Zamboni Lorenzo, Federico Angela, Tamburin Stefano
Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
PLoS One. 2017 Nov 30;12(11):e0188994. doi: 10.1371/journal.pone.0188994. eCollection 2017.
Erectile dysfunction (ED) is common among men on opioid replacement therapy (ORT), but most previous studies exploring its prevalence and determinants yielded contrasting findings. Moreover, the impact of ED on patients' quality of life (QoL) has been seldom explored.
To explore the prevalence and determinants of ED in men on ORT, and the impact on QoL.
In a multicentre cross-sectional study, we recruited 797 consecutive male patients on methadone and buprenorphine treatment, collected data on demographic, clinical, and psychopathological factors, and explored their role as predictors of ED and QoL through univariate and multivariate analysis. ED severity was assessed with a self-assessment questionnaire.
Nearly half of patients in our sample were sexually inactive or reported some degree of ED. Some demographic, clinical and psychopathological variables significantly differed according to the presence or absence of ED. Multivariate regression analysis indicated that age, employment, smoke, psychoactive drugs, opioid maintenance dosage, and severity of psychopathological factors significantly influenced the risk and severity of ED. QoL was worse in patients with ED and significantly correlated with ED severity. Age, education, employment, opioid maintenance dosage, ED score, and severity of psychopathology significantly influenced QoL in the multivariate analysis.
ED complaints can be explored in male opioid users on ORT through a simple and quick self-assessment tool. ED may have important effects on emotional and social well-being, and may affect outcome.
勃起功能障碍（ED）在接受阿片类药物替代疗法（ORT）的男性中很常见，但以往大多数探索其患病率和决定因素的研究结果却相互矛盾。此外，很少有人探讨ED对患者生活质量（QoL）的影响。
探讨接受ORT的男性中ED的患病率和决定因素，以及对生活质量的影响。
在一项多中心横断面研究中，我们连续招募了797名接受美沙酮和丁丙诺啡治疗的男性患者，收集了有关人口统计学、临床和精神病理学因素的数据，并通过单变量和多变量分析探讨了它们作为ED和QoL预测因素的作用。ED严重程度通过自我评估问卷进行评估。
我们样本中近一半的患者没有性活动或报告有一定程度的ED。一些人口统计学、临床和精神病理学变量根据是否存在ED有显著差异。多变量回归分析表明，年龄、就业情况、吸烟、精神活性药物、阿片类药物维持剂量和精神病理学因素的严重程度显著影响ED的风险和严重程度。ED患者的生活质量较差，且与ED严重程度显著相关。在多变量分析中，年龄、教育程度、就业情况、阿片类药物维持剂量、ED评分和精神病理学严重程度显著影响生活质量。
通过一种简单快速的自我评估工具，可以在接受ORT的男性阿片类药物使用者中探讨ED主诉。ED可能对情绪和社会幸福感有重要影响，并可能影响治疗结果。
