Jagdish Rakesh K, Kamaal Ahmed, Shasthry Saggere M, Benjamin Jaya, Maiwall Rakhi, Jindal Ankur, Choudhary Ashok, Rajan Vijayaraghavan, Arora Vinod, Bhardwaj Ankit, Kumar Guresh, Kumar Manoj, Sarin Shiv K
Department of Hepatology and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, India.
Department of Urology, Institute of Liver and Biliary Sciences, New Delhi, India.
J Clin Exp Hepatol. 2022 Sep-Oct;12(5):1264-1275. doi: 10.1016/j.jceh.2022.05.001. Epub 2022 May 10.
Erectile dysfunction (ED) is common in men with cirrhosis. The aim of this study was to assess the prevalence of ED and the factors associated with ED in men with cirrhosis.
400 men with cirrhosis [Child-Turcotte-Pugh (CTP) class A, 44.0%; CTP class B, 41.0%; and CTP class C, 15.0%] having high Karnofsky performance score, and living in a stable monogamous relationship with a female partner were included in the study. International Index of Erectile Function (IIEF) questionnaire, and Short-Form (36) Health Survey (SF-36) were used to assess erectile function and the health-related quality of life (HRQOL), respectively.
ED was found in 289 (72.3%) patients. Patients with ED reported significantly lower SF-36 scores across all the eight domains of SF-36 (i.e., physical functioning score, role physical score, bodily pain score, general health perception score, vitality score, social functioning score, role emotional score, and mental health score); physical component summary score, and mental physical component summary score, compared with those without ED. On multivariate analysis, factors associated with ED were older age, longer duration of cirrhosis, CTP-C (vs. CTP-A), higher hepatic venous pressure gradient (HVPG), presence of generalized anxiety disorder (GAD), presence of major depression, and lower appendicular skeletal muscle index measured by dual-energy X-ray absorptiometry (DEXA ASMI).
ED is common in men with cirrhosis, and men with ED have poor HRQOL compared with those without ED. Older age, longer duration of cirrhosis, CTP-C (vs. CTP-A), higher HVPG, presence of GAD, presence of major depression, and lower DEXA ASMI are associated with ED.
勃起功能障碍(ED)在肝硬化男性中很常见。本研究的目的是评估肝硬化男性中ED的患病率以及与ED相关的因素。
本研究纳入了400例肝硬化男性患者[Child-Turcotte-Pugh(CTP)分级:A级占44.0%;B级占41.0%;C级占15.0%],这些患者卡氏功能状态评分较高,且与女性伴侣保持稳定的一夫一妻制关系。分别使用国际勃起功能指数(IIEF)问卷和简明健康调查(SF-36)来评估勃起功能和健康相关生活质量(HRQOL)。
289例(72.3%)患者存在ED。与无ED的患者相比,ED患者在SF-36的所有八个领域(即身体功能评分、角色身体评分、身体疼痛评分、总体健康感知评分、活力评分、社会功能评分、角色情感评分和心理健康评分)、身体成分汇总评分和精神身体成分汇总评分上均显著较低。多因素分析显示,与ED相关的因素包括年龄较大、肝硬化病程较长、CTP-C级(与CTP-A级相比)、肝静脉压力梯度(HVPG)较高、存在广泛性焦虑障碍(GAD)、存在重度抑郁症以及通过双能X线吸收法(DEXA)测量的四肢骨骼肌指数较低。
ED在肝硬化男性中很常见,与无ED的男性相比,有ED的男性HRQOL较差。年龄较大、肝硬化病程较长、CTP-C级(与CTP-A级相比)、HVPG较高、存在GAD、存在重度抑郁症以及DEXA测量的四肢骨骼肌指数较低与ED相关。