心理性勃起功能障碍的海马氢质子波谱研究

目的:研究心理性勃起功能障碍(ED)患者海马代谢的改变,以期为心理性ED可能存在的潜在病因和病理生理机制的探讨提供线索。方法:运用磁共振波谱(MRS)研究15例心理性ED患者和15例年龄匹配的健康志愿者双侧海马的多体素氢质子(1H-MRS)波谱特点,测定N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)代谢物浓度,并分别对NAA/Cr和Cho/Cr的比值进行计算。结果:NAA/Cr在心理性ED组两侧海马(左侧为1.03±0.18,右侧为1.05±0.12)均低于正常对照组(左侧为1.25±0.10,右侧为1.21±0.07),差异有显著性(P<0.05);两组两侧Cho/Cr均无明显差异(心理性ED组左侧为1.20±0.82,右侧为1.22±0.95;对照组左侧为1.21±0.93,右侧为1.18±0.12)。结论:心理性ED可能不单纯是功能性疾病,海马可能参与了心理性ED的病理生理过程,心理性ED可能存在潜在的病因和病理生理机制。

1H-MRS of the Hippocampus of Psychogenic Erectile Dysfunction

Objective: To study the changes of the hippocampus metabolites with MRS to provide some clues for exploring the possible underlying unrecognised factors and pathophysiological mechanisms of psychogenic erectile dysfunction (ED). Methods: Fifteen cases of psychogenic erectile dysfunction and 15 normal volunteers (the control) were studied by a clinical (1.5)T MRI/MRS system. Proton multi-voxel spectroscopy imaging (~(1)H-MRSI) was obtained from both sides of the hippocampus region. N-acetylaspartate (NAA), creatine and phosphocreatine (Cr) and choline-containing compounds (Cho) were determined and the ratios of NAA/Cr and Cho/Cr were calculated respectively. Results: The NAA/Cr ratio was significantly lower in the ED patients than in the control (P<(0.05)). There was no significant difference in the Cho/Cr ratio between the two groups (P>(0.05)). Conclusion: Psychogenic erectile dysfunction may not be simply a functional disease. The hippocampus may be involved in the pathophysiology of psychogenic ED. The disease may have some previously unrecognised underlying aetiological factors and pathophysiological mechanisms.