阻塞性睡眠呼吸暂停低通气综合征患者手术前后性功能变化

目的 探讨内皮素（ET）和一氧化氮(NO)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 合并性功能障碍发病中的作用。方法 对OSAHS合并性功能障碍者30例和OSAHS性功能正常者32例手术前后测评其性功能、多导睡眠监测指标、血浆ET和血清NO，同时取健康男性10例作对照。结果 1. OSAHS性功能障碍组和OSAHS性功能正常组的睡眠呼吸暂停低通气指数（AHI）、ET均高于健康对照组，最低血氧饱和度（SaO₂）、NO均低于健康对照组(P＜0.01）。OSAHS性功能障碍组的最低SaO₂、NO低于性功能正常组，AHI高于性功能正常组（P＜0.05）。两组ET差异无统计学意义（P＞s0.05）；2. OSAHS患者的国际勃起功能指数5（IIEF-5）与最低SaO₂和NO呈正相关，与AHI和ET呈负相关（P＜0.05）；3. OSAHS合并性功能障碍组手术后与手术前比较，AHI和ET均降低，IIEF-5、最低SaO₂和NO升高（P＜0.01）。结论手术治疗可以改善OSAHS合并性功能障碍患者的性功能。NO在OSAHS患者并发性功能障碍的过程中发挥一定作用。

Erectile function in patients with obstructive sleep apnea hypopnea syndrome after operation

ObjectiveTo explore the role of endothelin(ET) and nitric oxide (NO) in the pathogenesis of erectile dysfunction (ED) in obstructive sleep apneahypopnea syndrome (OSAHS). MethodsThe International index oferectile function （IIEF-5）, plasma ET, serum NO and polysomnographic (PSG) parameters in 30 OSAHSpatients with accompanied erectile dysfunction and 32 normal erectile OSAHS patients were determined before and after operation. 10 normal subjects served ascontrols. Results1. Compared with normal people, the apnea hypopnea index(AHI ) and ET were increased in OSAHS patients with or without ED, while the lowest SaO2 and NO were decreased （P＜0.01）. The lowest SaO2 and NO inOSAHS patients with ED were lower than those in OSAHS patients without ED, AHI in OSAHS patients with ED was higher than that in OSAHS patients without ED （P＜0.05）. There was no significant difference in ET in the two groups（P＞0.05）.2. In OSAHS patients, IIEF-5 positively correlated with the lowest SaO2 and NO and negatively correlated with AHI and ET （P＜0.05）. 3. In OSAHS patients with ED, AHI and ETweredecreased after the operation, while IIEF-5, the lowest SaO2 and NO were increased after the operation（P＜0.01）. Conclusion Operation is effective for OSAHSpatients with accompanied erectile dysfunction. NO may play a role in the pathogenesis of OSAHS-induced erectile dysfunction.