与无炎症性肠病男性相比，溃疡性结肠炎和克罗恩病男性勃起功能障碍药物使用增加：一项全国性队列研究。
Increased Use of Medications for Erectile Dysfunction in Men With Ulcerative Colitis and Crohn's Disease Compared to Men Without Inflammatory Bowel Disease: A Nationwide Cohort Study.
机构信息
Center for Crohn's and Colitis, Brigham and Women's Hospital, Chestnut Hill, MA, USA. Harvard Medical School, Boston, MA, USA. 3Center for Clinical Epidemiology, Odense University hospital, and Research Unit of Clinical Epidemiology, institute of Clinical Research, University of southern Denmark, Odense, Denmark. Department of Gastroenterology, Beaumont hospital and Royal College of surgeons of ireland, Dublin, ireland. Centre of Andrology and Fertility Clinic, Department D, Odense University hospital, and Research Unit of human Reproduction, institute of Clinical Research, University of southern Denmark, Odense, Denmark.
出版信息
Am J Gastroenterol. 2018 Sep;113(9):1355. doi: 10.1038/s41395-018-0177-6. Epub 2018 Jul 10.
BACKGROUND
Men with inflammatory bowel disease (IBD) may have decreased sexual function due to factors related to the underlying disease, medication, and/or surgery. We aimed to examine the use of erectile dysfunction (ED) medications in men with IBD.
METHODS
This is a nationwide cohort study based on the Danish registries, comprising all men >18 years old with IBD during 1 January 1995 through December 2016. The cohorts included 31,498 men with IBD and 314,980 age-matched men without IBD. Our main outcome was a first prescription of an ED medication. Cox regression analyses were used to estimate the hazard rate (HR) for use of ED medications, controlled for multiple time-varying covariates.
RESULTS
Overall, 21,966 (69.7%) men had ulcerative colitis (UC) while 9532 (30.3%) had Crohn's disease (CD). Men with a first ED prescription numbered 3749 (11.9%) (men with IBD) and 30,635 (9.7%) (men without IBD). Adjusting for central nervous system and intestinal anti-inflammatory medications, systemic corticosteroids and co-morbidities, the HR was 1.19 (95% CI: 1.13-1.26) (IBD and no prior IBD operation), and 1.31 (95% CI: 1.20-1.43) (IBD and prior IBD operation). The adjusted HR for UC was 1.17 (95% CI: 1.10-1.24) (no operation) and 1.43 (95% CI: 1.27-1.61) (prior operation), and for CD 1.26 (95% CI: 1.15-1.38) (no operation) and 1.20 (95% CI: 1.06-1.35) (prior operation).
DISCUSSION
Men with IBD are more likely to fill an ED prescription than men without IBD. This result is significant regardless of a history of IBD surgery.
背景
炎症性肠病（IBD）患者可能由于与基础疾病、药物和/或手术相关的因素而导致性功能下降。我们旨在研究 IBD 男性中勃起功能障碍（ED）药物的使用情况。
方法
这是一项基于丹麦登记处的全国性队列研究，包括 1995 年 1 月 1 日至 2016 年 12 月期间所有年龄大于 18 岁的 IBD 男性患者。队列包括 31498 例 IBD 男性和 314980 名年龄匹配的无 IBD 男性。我们的主要结局是首次开具 ED 药物处方。使用 Cox 回归分析估计 ED 药物使用的风险比（HR），并控制了多个随时间变化的协变量。
结果
总体而言，21966 例（69.7%）男性患有溃疡性结肠炎（UC），9532 例（30.3%）患有克罗恩病（CD）。首次开具 ED 处方的男性人数为 3749 例（11.9%）（IBD 男性）和 30635 例（9.7%）（无 IBD 男性）。调整中枢神经系统和肠道抗炎药物、全身皮质类固醇和合并症后，HR 为 1.19（95%CI：1.13-1.26）（IBD 且无先前 IBD 手术）和 1.31（95%CI：1.20-1.43）（IBD 且有先前 IBD 手术）。UC 的调整 HR 为 1.17（95%CI：1.10-1.24）（无手术）和 1.43（95%CI：1.27-1.61）（先前手术），CD 的调整 HR 为 1.26（95%CI：1.15-1.38）（无手术）和 1.20（95%CI：1.06-1.35）（先前手术）。
讨论
IBD 男性比无 IBD 男性更有可能开具 ED 处方。无论是否有 IBD 手术史，这一结果均具有统计学意义。
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