用于勃起功能障碍鉴别与分类的阴茎勃起强度测量带
[Penile erectile strength measurement band for differentiation and classification of erectile dysfunction].
作者信息
Lin Zi-Bin, Deng Jun-Hong, Huang Liang-Liang, Shi Hua, Liu Jian-Ming, Ou-Yang Bin, Xie Jing-Xuan
机构信息
Department of Andrology, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong 510180, China.
出版信息
Zhonghua Nan Ke Xue. 2018 Jun;24(6):520-524.
OBJECTIVE
To study the clinical application value of the penile erectile strength measurement (PESM) band in the differentiation of psychogenic from organic erectile dysfunction (ED).
METHODS
Eighty ED patients unable to achieve or maintain adequate penile erection to complete sexual intercourse were included in the experimental group and another 40 healthy subjects with normal erectile function enrolled as controls. The ED cases were classified into mild, moderate and severe ED according to the IIEF-5 scores and divided into psychogenic and organic ED based on the results of the nocturnal penile tumescence (NPT) test. Then all the subjects underwent a three-night continuous monitoring with the PESM band and, according to the band fracture rate, the ED cases were also classified into psychogenic and organic ED. The rates of missed diagnosis, misdiagnosis and diagnostic coincidence of PESM were calculated with the results of NPT as the standard for differentiating psychogenic from organic ED.
RESULTS
The results of NPT tests revealed 51 cases of psychogenic and 29 cases of organic ED in the experimental group. The band fracture rate in PESM was 95.0% in the mild, 80.9% in the moderate and 52.8% in the severe ED patients. Of the 51 cases of psychogenic ED detected by NPT test, 43 were diagnosed as psychogenic and the other 8 as organic ED with the PESM band, with a coincidence rate of 84.3%. Of the 29 cases of organic ED revealed by NPT test, 5 were diagnosed as psychogenic and the other 24 as organic ED by PESM, with a coincidence rate of 82.8%. Normal erectile function with three-level fracture of the band was observed in the PESM of the normal controls, which showed a coincidence rate of 100% with the results of NPT tests. Based on the standard of the NPT test, the rates of missed diagnosis, misdiagnosis and diagnostic coincidence of the PESM band in differentiating psychogenic from organic ED were 15.7%, 17.2%, and 83.8%, respectively, with a Kappa value of 0.656 (P <0.05).
CONCLUSIONS
The penile erectile strength measurement band can be used as a screening tool for initial differentiation of psychogenic from organic ED.
目的
探讨阴茎勃起强度测量（PESM）带在鉴别心理性与器质性勃起功能障碍（ED）中的临床应用价值。
方法
将80例无法达到或维持足够阴茎勃起以完成性交的ED患者纳入实验组，另选40例勃起功能正常的健康受试者作为对照组。根据国际勃起功能指数-5（IIEF-5）评分将ED病例分为轻度、中度和重度ED，并根据夜间阴茎胀大（NPT）试验结果分为心理性和器质性ED。然后所有受试者使用PESM带进行连续三晚的监测，并根据带子断裂率将ED病例也分为心理性和器质性ED。以NPT结果作为鉴别心理性与器质性ED的标准，计算PESM的漏诊率、误诊率和诊断符合率。
结果
NPT试验结果显示实验组中有51例心理性ED和29例器质性ED。PESM中，轻度ED患者的带子断裂率为95.0%，中度为80.9%，重度为52.8%。在NPT试验检测出的51例心理性ED病例中，PESM带诊断为心理性的有43例，诊断为器质性的有8例，符合率为84.3%。在NPT试验显示的29例器质性ED病例中，PESM诊断为心理性的有5例，诊断为器质性的有24例，符合率为82.8%。正常对照组的PESM显示带子三级断裂时勃起功能正常，与NPT试验结果的符合率为100%。以NPT试验为标准，PESM带在鉴别心理性与器质性ED时的漏诊率、误诊率和诊断符合率分别为15.7%、17.2%和83.8%，Kappa值为0.656（P<0.05）。
结论
阴茎勃起强度测量带可作为初步鉴别心理性与器质性ED的筛查工具。
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