夜间生物电阻抗容积测定在血管性勃起功能障碍诊断中的应用

目的探讨夜间生物电阻抗容积测定(NEVA)在诊断血管性勃起功能障碍(ED)中的临床应用价值。方法对临床怀疑血管性ED的58例患者进行NEVA测定,其结果与阴茎海绵体造影联合彩超的诊断结果进行比较,从而了解NEVA在诊断血管性ED中的临床应用价值.结果58例患者中确诊血管性ED的患者有30人,其中18名为动脉性ED,12名为静脉性ED,非血管性ED的患者有28人。应用NEVA发现在30名血管性ED的患者中有6名NPT正常,在28名非血管性ED的患者中有4名NPT有异常。NEVA对血管性ED诊断的敏感度为80%,特异度为85.71%,准确度为82.76%。在非血管组、动脉组、静脉组中有统计学差异的NEVA参数为:每晚勃起次数、勃起持续时间、血容量改变、横截面改变。结论NEVA对临床上怀疑血管性ED的诊断有参考价值。     

NEVA在不同原因勃起功能障碍诊断中的应用

目的探讨NEVA在不同原因勃起功能障碍(ED)诊断中的作用。方法应用NEVA分别对15例勃起功能正常、18例心理(ED)性、16例阴茎动脉供血不足及8例阴茎静脉瘘者进行NPT监测。结果正常组夜间勃起血容量(?)分比228.5±14.0,勃起持续时间42.8±4.0min。心理性ED组分别为224.4±20.1及40.8±4.4,二项参数与正常组无显著性差异异(P>0.05)。阴茎动脉供血不足组,这两项指标分别为160.1±12.4及22.9+3.0,阴茎静脉瘘组分别为124.4±10.2及18.0±2.5,器质性ED这两项参数低于正常组与心理性ED组,呈显著性差异(P<0.01)。结论在筛选ED和诊断血管性ED中,NEVA是有效、易被病人接受的一种NPT检查工具。     

阴茎夜间勃起监测系统NEVA在勃起功能障碍诊断中的应用

目的 探讨夜间阴茎勃起监测系统对勃起功能障碍(ED)诊断的应用价值.方法 应用国产伟力NEVA夜间阴茎勃起监测系统对正常志愿者(32例)、心理性ED患者(63例),动脉性ED患者(61例)和静脉性ED患者(28例),检查阴茎血容积变化率、阴茎勃起次数、每次勃起持续时间、阴茎长度变化率及阴茎周径变化率.结果 正常志愿者组及心理性ED组的阴茎血容积变化率为231.5±112.5及221.8±96.7,每次勃起持续时间分别为(27.2±12.5)min及(25.9±11.1)min,这两项指标两组比较,差异均无统计学意义,P均＞0.05.而动脉性ED组及静脉性ED组的以上两项指标为172.8±56.8及130.6±22.1,(20.1±8.6)min及(18.1±10.5)min,这两项指标两组比较,差异均无统计学意义,P均＞0.05.NEVA对动脉性及静脉性ED诊断的准确率分别为91.8%和96.4%.结论 NEVA夜间阴茎勃起监测系统在ED筛选和血管性ED诊断中是有效的、易于接受的方法.     

年龄对勃起功能障碍患者夜间勃起检测结果的影响

目的:随着年龄的增长,心理性和器质性ED的构成比发生变化。本文旨在探讨不同年龄组勃起功能障碍患者应用夜间生物电阻抗容积测定(NEVA)的结果及意义。方法:83例ED患者根据年龄分为4组,并应用NEVA对各患者进行夜间勃起试验(NPT)检测。结果:心理性ED49例,器质性ED34例,随着年龄的增长,器质性ED所占的比例由30.3%升至60.0%,而心理性ED的比例则由69.7%降至40.0%。结论:随着年龄的增长,器质性ED比例有升高的趋势,心理性ED则相反。     

重复NEVA检测结合HEF-5在阴茎勃起功能障碍（ED）诊断中的意义

目的探讨重复夜间阴茎勃起测定系统（NEVA）结合国际勃起功能评分（IIEF-5）在勃起功能障碍（ED）诊断中的可行性及临床意义。方法对90例门诊ED患者用IIEF-5对其评分，再连续3晚进行NEVA检测，回收数据并分析。结果无器质性疾病52例（58％），第1次夜间勃起的次数、阴茎勃起时血容量变化值、最长持续时间等客观指标均要差于连续测定结果，差异有统计学意义（P〈0．05）。IIEF-5评分值与NEVA检测阴茎勃起时血容量变化值有正相关。结论NEVA与IIEF-5结合有互补性。重复NEVA并与IIEF-5结合分析，能减小数据误差，提高诊断ED的可靠性，能有效地区分功能性与器质性ED。尤其对怀疑夜间阴茎勃起（NPT）检查结果有误差的特殊病例更有价值。     

重复NEVA检测结合IIEF-5在阴茎勃起功能障碍(ED)诊断中的意义

目的 探讨重复夜间阴茎勃起测定系统(NEVA)结合国际勃起功能评分(IIEF-5)在勃起功能障碍(ED)诊断中的可行性及临床意义.方法 对90例门诊ED患者用IIEF-5对其评分,再连续3晚进行NEVA检测,回收数据并分析.结果 无器质性疾病52例(58%),第1次夜间勃起的次数、阴茎勃起时血容量变化值、最长持续时间等客观指标均要差于连续测定结果,差异有统计学意义(P＜0.05).IIEF-5评分值与NEVA检测阴茎勃起时血容量变化值有正相关.结论 NEVA与IIEF-5结合有互补性.重复NEVA并与IIEF-5结合分析,能减小数据误差,提高诊断ED的可靠性,能有效地区分功能性与器质性ED.尤其对怀疑夜间阴茎勃起(NPT)检查结果有误差的特殊病例更有价值.     

彩色多普勒超声和夜间生物电阻抗容积测定对阴茎勃起功能障碍诊断的比较

目的:探讨彩色多普勒超声(CDUS)和夜间生物电阻抗容积测定(NEVA)对勃起功能障碍(ED)诊断的相互关系及后者对ED病因的诊断价值。方法:应用CDUS及NEVA分别检测45例ED患者的阴茎勃起情况,基于CDUS检测结果将ED患者分为动、静脉性及非血管性3组,对NEVA各参数进行组间两两比较,并探讨两种检查方法之间的相互关系。结果:非血管性ED组NEVA结果正常达94.4%,而动、静脉性ED组NEVA结果异常分别为75.0%和72.7%。NEVA各参数3组间相互比较仅静脉性ED组的阴茎血容量改变明显低于非血管性ED组(P=0.033)。结论:NEVA结果正常与否和CDUS提示的动、静脉功能良好与否存在较好的一致性;NEVA在一定程度上可以反映阴茎血管功能状况,提示ED的病因。     

彩色双功能多普勒超声联合夜间阴茎勃起测定对骨盆骨折后阴茎勃起功能的评价(附34例分析)

目的探讨骨盆骨折对ED患者阴茎勃起功能的影响程度,并寻求较佳的评价方法。方法34例骨盆骨折后ED患者,给予海绵体内注射血管活性药物(ICI,酚妥拉明1mg、罂粟碱30mg)并行彩色双功能多普勒超声(CDDU)检查阴茎血流动力学,结合夜间阴茎勃起测定(NPT)连续3夜测定阴茎勃起次数、持续时间、血容积的变化情况。结果34例骨盆骨折后ED患者的阴茎海绵体动脉收缩期最大血流速度(PSV)左侧为(23.778.6)1cm/s,右侧为(24.086.7)7cm/s;动脉舒张期最小血流速度(EDV)左侧为(2.3033.2)5cm/s,右侧为(3.361.5)2cm/s;阴茎血管阻力指数(RI)为0.910.1。2全部病例均存在NPT异常,血容积变化率为(162.6830.4)8%;结论CDDU NPT可以作为骨盆骨折后ED的一种有效评价方法。     

脊柱或骨盆损伤后阴茎勃起功能障碍的病因分析

目的 分析脊柱或骨盆损伤后阴茎勃起功能障碍(ED)的可能病因.方法 回顾性分析2005-2009年收治的67例因脊柱或骨盆损伤后ED患者资料.年龄18 ～64岁,平均32岁.伤后时间3～144个月,平均38个月.其中骨盆骨折56例(84％),脊柱外伤11例(16％).患者自诉受伤前性功能正常.患者在未服用或停用PDE-5抑制剂的情况下进行IIEF-5评分、夜间勃起监测(NPT,Rigiscan系统,连续检测3晚)、阴茎彩色多普勒超声(CDU)检查.NPT检测夜间勃起＜3次,每次阴茎头部勃起硬度＜70％,时间＜ 10 min诊断为器质性ED.阴茎Ⅳ度勃起情况下,CDU检查峰收缩期速率(PSV)＜ 25 cm/s诊断为动脉性ED;PSV＞ 25 cm/s,舒张末期速率(EDV) ＞5 cm/s诊断为静脉性ED;排除其他原因的器质性ED诊断为神经性ED.结果 62例患者在6个月内未尝试性生活,5例患者IIEF-5评分5～8分.NPT检测证实62例患者均为器质性ED,其中骨盆骨折患者中神经性ED 24例(43％),动脉性ED 22例(39％),静脉性ED 10例(18％);脊柱外伤患者均为神经性ED.结论 骨盆骨折或脊柱外伤可导致器质性ED.骨盆骨折导致的ED可能合并血管性因素,而脊柱外伤所致ED为神经性.     

夜间阴茎勃起测定系统筛选勃起功能障碍病人的临床应用

目的 :探讨应用尼娃牌 (NEVA)夜间阴茎勃起测定系统筛选勃起功能障碍 (ED)的可行性及意义。　方法 :2 0例门诊ED病人 ,睡前正确粘贴NEVA测定仪电极 ,带机过夜 ,次日数据回放输入主机分析。　结果 :全部病人均可耐受测定 ,依从性好 ,15例病人资料提示阴茎无器质性疾病 ,4例提示阴茎动脉供血不足 ,1例可疑阴茎静脉漏 ,3种病例勃起事件分别为 ( 4 .0± 0 .4 )、( 3 .2± 0 .3 )、( 2 .0± 0 )次 ,阴茎截面积最大改变量分别为( 0 .178± 0 .0 18)、( 0 .0 80± 0 .0 0 4 )、( 0 .13 5± 0 )cm2 ,平均勃起状态阴茎血容量分别为基准水平的 ( 2 2 5 .5± 12 .0 ) %、( 14 5 .2± 10 .6) %、( 12 8.0± 0 ) %。　结论 :尼娃牌夜间阴茎勃起测定系统操作简便、易行、无创伤 ,可区分心理性、血管性ED。     

The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction

The aim of this study was to investigate the relationship between penile color Doppler sonography (CDS) findings and sonographic endothelial parameters in patients with erectile dysfunction (ED), including intima-media thickness (IMT) of common carotid arteries (CCA) and flow-mediated dilatation (FMD) of brachial artery. Fifty-six ED patients were included in the study. Penile CDS, IMT of CCA and FMD of brachial artery were performed in all patients. According to penile CDS findings, 27 (48%) patients had non-vasculogenic and 29 (52%) patients had vasculogenic ED. Among 29 patients, 17 (30%) patients had cavernous veno-occlusive disease (CVOD) and 12 (22%) patients had arterial/combined insufficiency (AI). Median (interquartile range) FMD values of non-vasculogenic ED, CVOD and AI were 12.50 (6.54)%, 12.82 (7.41)% and 6.25 (7.17)%, respectively. FMD was found to be impaired significantly in AI group when compared to the other groups. FMD values of CVOD group were lower when compared to non-vasculogenic group, but the difference was not statistically significant. IMT values of vasculogenic ED patients were higher than non-vasculogenic ED patients (P<0.05). Although IMT values were higher in AI group when compared to CVOD, the difference was not statistically significant. The combined use of IMT and FMD established the diagnosis of vasculogenic ED with 100% sensitivity and 59.2% specificity. The positive predictive value was 72%, negative predictive value 100% and accuracy 80%. The combined use of brachial artery FMD and carotid arteries IMT measurements may be suggested as an alternative method to evaluate vasculogenic ED.     

勃起功能障碍诊断方法探讨

目的:探讨ED的诊断方法。方法:对365例11个民族拟诊为血管性ED的患者分别采用阴茎海绵体注射试验、阴茎-肱动脉血压指数测定、阴茎彩色双功能超声、阴茎海绵体造影、阴茎数字减影血管造影及阴茎动、静脉血池显像等检查。结果:有365、204、168、228、142、136例患者分别接受了上述6种检查。诊断动脉性ED82例,静脉性ED132例,混合性ED57例,原因不明ED94例。不同民族间差异无统计学意义(P>0.05)。结论:ED是高度个性化疾病,针对ED患者不同情况采取相应的诊断方法有利于选择高效、经济、安全的治疗方法。     

The role of colour duplex ultrasonography in the diagnosis of vasculogenic impotence.

Colour duplex ultrasonography was used to obtain peak systolic velocity (PSV) readings from cavernosal arteries at rest and during papaverine-induced tumescence. Results from 31 men with vasculogenic impotence were compared with those from 17 men with non-vasculogenic impotence and a control group of 6 potent men. In the flaccid state no significant differences in PSV readings were found between the vasculogenic and control groups. Following the injection of papaverine, men from the vasculogenic group without venous leakage were alone in having significantly lower PSV readings compared with the potent controls. All 23 men with normal penile haemodynamics had a mean PSV greater than or equal to 20 cm/s during tumescence. This was also the case for 19 (61%) of the vasculogenic group, including 9 (69%) of the 13 patients with venous leakage. The remaining 12 men in the vasculogenic group (39%) had a mean PSV less than 20 cm/s, this being diagnostic of an inadequate arterial inflow. Colour duplex ultrasonography can identify patients who have marked arterial insufficiency as the major cause of their impotence and hence allows more rational selection for angiography and revascularisation. Lesser degrees of arterial deficit are difficult to characterise using mean PSV readings alone.     

西地那非对夜间勃起作用的研究

目的:探讨西地那非对夜间勃起的作用。方法:对35例勃起功能障碍(ED)患者予以西地那非100 mg睡前口服,其中器质性28例,心理性7例。用尼娃(NEVA)监测夜间勃起情况。结果:28例器质性ED患者的勃起参数有明显改善(P<0.05),7例心理性ED患者无明显改善(P>0.05)。结论:在无性刺激条件下西地那非可改善器质性ED患者夜间勃起。     

Nocturnal electrobioimpedance volumetric assessment in diabetic men with erectile dysfunction before and after tadalafil intake

Nocturnal electrobioimpedance volumetric assessment (NEVA) is a procedure that can measure penile volume changes together with the number and duration of nocturnal erectile events. This study was conducted to evaluate the different NEVA patterns in diabetic patients with erectile dysfunction (ED), and demonstrate the extent to which tadalafil may affect the characteristics of nocturnal penile erections in these patients. Therefore, 38 patients with noninsulin-dependent diabetes and ED participated in this study. They were assessed with history intake including evaluation by the abridged five-item version of International Index of Erectile Function, clinical and psychiatric assessment and NEVA for three consecutive nights where placebo was given on the second night and tadalafil on the third night. In all, 14 potent males were taken as a control group. Data were analyzed using t-test. Results showed normal patterns in only six (16%) patients (central organic group), while abnormal patterns were observed in the remaining 32 (84%) patients (peripheral organic group). These abnormal patterns showed significant decrease in both the number (P=0.0001) and duration (P=0.03) of erectile events compared to those of controls. The percentage of penile blood volume change over baseline also decreased significantly (P=0.0002) relative to controls. Veno-occlusive dysfunction was the main pathology (23 patients, 72%) as suggested by NEVA. Tadalafil did not significantly change basal nocturnal penile tumescence results in either the central organic or control groups, but it did so significantly in the peripheral organic group (P=0.02 for duration change and P=0.01 for % blood volume change). In conclusion, NEVA may suggest some evidence about the pathophysiology of an underlying vasculogenic cause, thus directing towards the next specific step needed for a precise diagnosis. Tadalafil improves nocturnal erections in diabetic patients with peripheral but not central organic impotence.     

IIEF-5在血管性勃起功能障碍诊断中的应用

目的:评价国际勃起功能简化量表(IIEF-5)对血管性勃起功能障碍(ED)病因区分的意义,以指导血管性ED诊断及治疗。方法:将103例ED患者分为4组,非血管性ED组37例(37/103,35.9%)、动脉性ED组18例(18/103,17.5%)、静脉性ED组35例(35/103,34.0%)、混合性ED组13例(13/103,12.6%),其IIEF-5得分与海绵体血管活性药物注射试验结果、多普勒超声检查结果及双核素检测结果进行比较,以非参数检验的多个独立样本检验(Kruskal-WallisTEST)比较各组之间IIEF-5得分差异的显著性。结果:上述4组之间的IIEF-5得分没有统计学差异(P=0.253)。结论:IIEF-5不能作为一种诊断工具用于鉴别血管性ED的病因以及判断血管病变严重程度。     

彩色多普勒超声检查在血管性勃起功能障碍诊断中的应用

目的 :探讨多普勒超声检查在诊断血管性勃起功能障碍 (ED)的临床价值。　方法 :应用多普勒超声检查阴茎药物诱导勃起前后的血液动力学改变 ,将非血管性ED病人与明确诊断血管性ED病人的多普勒超声变化进行对比 ,寻找血管性ED的特征。　结果 :动脉性ED病人深动脉的最大血流速度 (PSV)明显小于正常组 (P <0 .0 1) ;静脉性ED病人在阴茎完全勃起后背深静脉血流 (VV)仍大于对照组 (P <0 .0 5 )。　结论 :配合药物诱导阴茎勃起 ,多普勒超声检查是临床上筛选血管性ED的有效手段