甲状腺功能亢进对勃起功能障碍的患者血管内皮功能的影响

发布时间：2018-06-23 01:37

本文选题：甲状腺功能亢进症 + 血管内皮　；参考：《河北医科大学》2014年硕士论文

【摘要】：目的：勃起功能障碍(erectile dysfunction, ED),指阴茎持续不能达到和(或)维持足够的勃起以获得满意的性生活(性交),是最常见的性功能障碍性疾病,分为轻中重度。随着年龄增长重度ED的发病率呈上升趋势。有学者认为勃起功能障碍可能是全身动脉硬化的先兆。甲状腺是人体重要的内分泌腺之一,主要合成释放甲状腺激素。甲状腺功能亢进(Hyperthyroidism,简称甲亢)是由于甲状腺合成释放过多的甲状腺激素,造成机体代谢亢进和交感神经兴奋,引起心悸、出汗、进食和便次增多和体重减少的病症。是一种较常见的内分泌疾病。其病因主要包括弥漫性毒性甲状腺肿(Graves病)、多结节性毒性甲状腺肿和甲状腺自主高功能腺瘤(Plummer病)等。有研究发现甲亢严重时可能会引起血管内皮损伤导致动脉硬化、心脏功能衰竭、脑血管意外等。而血管内皮损伤被认为是ED的主要发病机制。本研究通过比较ED合并甲亢患者与正常患者间的血管内皮和勃起功能的差异,探讨甲亢对ED患者血管内皮的影响,为今后临床上更好的治疗ED提供理论依据。方法：选择2012年12月-2014年8月就诊我院的ED患者和甲亢患者共81例为试验组,其中A组为单纯甲亢组24例,B组单纯ED组46例,C组为ED合并甲亢组11例,同时选择同期的正常人群为D组(对照组)55例。(1)统计所有研究对象的年龄、BMI、腰臀比,并于上午8：00安静状态下测量收缩压、舒张压。同时抽血肘静脉血5毫升离心,收集血清待测总睾酮。(2)国际勃起功能指数(IIEF-5评分)标准：总分25分,≥22分无ED,22分判定为ED,5-7分为重度ED,8-11分为中度ED,12～21分为轻度ED。(3)血管扩张功能(flow mediated dilation,FMD)检测方法：用二维超声仪测量右上肢肱动脉内径(DO),然后进行反应性充血试验组后测定右上肢肱动脉内径(D1),FMD=[(D1-D0)/D0]×l00%。FMD的评分标准为：FMD10%为血管内皮功能正常,FMD10%为血管内皮功能受损。米用SPSS17.0分析软件对各组间HEE-5评分及FMD会下进行独立样本。t检验,数据以x±s表示,多组间的其他影响因素数据进行方差分析,P0.05表示差异有统计学意义。结果：(1)年龄、BMI、腰臀比、收缩压、舒张压、总睾酮比较：试验组与对照组以及三组试验组组间比较差异无统计学意义,P0.05。(2)IIEF-5评分比较：B组,C组与D组比较差异有统计学意义,P0.05,B组,C组IIEF-5评分低于D组；A组与D组比较差异无统计学意义,P0.05。A、B、C三组组间比较差异有统计学意义,P0.05,其中C组IIEF-5评分最低,B次之。(3)FMD值比较：A、B、C三组与对照组间比较差异有统计学意义,P0.05,A、B、C三组FMD值均低于D组；A、B、C三组组间比较差异有统计组意义,P0.05,其中C组FMD值最低,B次之,A组最高。结论：本研究中通过对试验组与对照组之间的年龄、身高、腰围、臀围、睾酮及血压的比较,说明所有入选对象有可比性。其中B组,C组与D组IIEF-5评分的比较,B组,C组IIEF-5评分低于D组,A、B、C三组组间的比较,其中C组IIEF-5评分最低,B次之,推测甲状腺功能可能影响患者勃起功能；A、B、C三组与对照组间FMD值比较差异有统计学意义,A、B、C三组FMD值均低于D组,A、B、C三组组间比较FMD值差异有统计组意义,其中C组FMD值最低,B次之,A组最高,推测甲状腺功能亢进可能导致患者的血管内皮功能受损,影响勃起功能。
[Abstract]:Objective: erectile dysfunction (ED) is the most common sexual dysfunction of the penis, which is the most common sexual dysfunction, and is divided into moderate and severe cases. The incidence of severe ED increases with age. Some scholars believe that erectile dysfunction is possible. It is a precursor of systemic arteriosclerosis. Thyroid is one of the most important endocrine glands in the human body. It is the main synthesis of thyroid hormones. Hyperthyroidism (Hyperthyroidism) is due to thyroid hormone synthesis and release of excessive thyroid hormones, causing the body to metabolize Kang Jinhe sympathetic nerve, causing palpitations, sweating, eating and stool. The disease of increased and weight loss is a more common endocrine disease. The causes include diffuse toxic goiter (Graves disease), multiple nodular goiter and thyroid autonomic adenoma (Plummer's disease). Failure, cerebrovascular accident, and so on. Vascular endothelial injury is considered to be the main pathogenesis of ED. This study compares the vascular endothelium and erectile function between ED combined with hyperthyroidism and normal patients, and discusses the effect of hyperthyroidism on the vascular endothelium of ED patients, and provides a theoretical basis for the better treatment of ED in the future. In August -2014 December 2012, 81 cases of ED patients and hyperthyroidism patients were tested in our hospital, of which group A was 24 cases of simple hyperthyroidism, 46 in group B alone, 46 in group ED, and 11 in group ED with hyperthyroidism, and 55 in group D (control group) at the same time. (1) the age, BMI, waist hip ratio, and 8:00 am at 8:00 am. In the static state, the systolic pressure and diastolic pressure were measured. 5 ml centrifugation was used to collect the blood of the elbow vein and collect the total testosterone. (2) the international erectile function index (IIEF-5 score) standard: total score 25, 22 points without ED, 22 points of ED, 5-7 divided into severe ED, 8-11 to moderate ED, 12~21 to mild (3) vasodilatation (flow mediated dilatio) N, FMD) detection methods: the internal diameter of the brachial artery in the right upper limb (DO) was measured by a two-dimensional ultrasound apparatus, then the internal diameter of the brachial artery (D1) in the right upper limb was measured after the reactive hyperemia test group. The standard of FMD=[(D1-D0) /D0] x l00%.FMD was as follows: FMD10% was normal of the vascular endothelial function and the vascular endothelial function was damaged by FMD10%, and the SPSS17.0 analysis software was used in each group. Between HEE-5 score and FMD, the independent sample.T test was carried out. The data were expressed in X + s, and the other factors of other factors were analyzed by variance. P0.05 indicated that the difference was statistically significant. Results: (1) age, BMI, waist to hip ratio, systolic pressure, diastolic pressure and total testosterone comparison: there was no difference between the experimental group and the control group and the three groups. Statistical significance, P0.05. (2) IIEF-5 score comparison: B group, C group and D group have statistical significance, P0.05, B group, C group IIEF-5 score lower than the D group, A group and D group, there is no statistical significance. There was significant difference between the group and the control group. The FMD values of P0.05, A, B, C three were all lower than those in the D group, and there were statistical differences between the groups of A, B, and C three groups, P0.05, and C group FMD values were the lowest. Compared with group B, group C and group D, the IIEF-5 score of group B and C was lower than that of group D, A, B, C three groups, among which the C group score was the lowest, and the thyroid function might affect the erectile function of the patients. Three groups of FMD values were lower than the D group, A, B, C three groups compared with the difference of FMD value of statistical significance, of which C group FMD value is the lowest, B times, the highest in the A group, presumed that hyperthyroidism may lead to damage to the vascular endothelial function of the patient, affecting the erectile function.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581.1;R698

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