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目的探讨夜间勃起功能监测(nocturnal penile tumescence,NPT)结果与血管内皮功能(vascular endothelial function)的相关性。方法本前瞻性研究从2010年1月至2011年6月入组30例健康志愿者设为A组(健康对照组),入组40例NPT正常的勃起功能障碍(erectile dysfunction,ED)患者设为B组(NPT正常ED组),入组40例NPT异常的ED患者设为C组(NPT异常ED组)。入组时3组受试者血清总睾酮均>9.9nmol/L,并排除代谢综合征(metabolic syndrome,MS)诊断。入组时3组受试者腰围、体质指数(BMI指数)、空腹血糖(FPG)、平均动脉压(MAP)、三酰甘油(TG)、高密度脂蛋白(HDL)、总胆固醇(CHOL)、血清总睾酮(TT)及肱动脉血流介导的血管扩张功能(flow mediated dilation,FMD)两两组间差异均无统计学意义(P>0.05),B、C两组IIEF-5评分差异无统计学意义(P>0.05)。4年后随访,再次测定IIEF-5评分及FMD值,并比较。结果 4年后随访时失访,A组2例,B组5例,C组8例。4年后随访,A、B两组除IIEF-5评分外,其他指标差异均无统计学意义(P>0.05);A、C两组比较,MAP、FPG、HDL、IIEF-5评分及FMD值差异均有统计学意义(P<0.05);B、C两组比较,MAP、HDL、IIEF-5评分及FMD值差异均有统计学意义(P<0.05)。结论 NPT结果可在一定程度上反映血管内皮功能状态,可能比FMD值更为敏感,因简单无创,可作为早期预警血管内皮功能障碍的参考指标之一。
Objective To investigate the correlation between nocturnal penile tumescence (NPT) findings and vascular endothelial function. Methods The prospective study of 30 healthy volunteers from January 2010 to June 2011 was enrolled as group A (control group). Forty patients with normal NPT with erectile dysfunction (ED) For group B (NPT normal ED group), 40 patients with NPT abnormal ED were enrolled as group C (NPT abnormal ED group). The total testosterone in all three groups was> 9.9nmol / L at the time of enrollment, and metabolic syndrome (MS) diagnosis was excluded. The waist circumference, body mass index (BMI), fasting blood glucose (FPG), mean arterial pressure (MAP), triglyceride (TG), high density lipoprotein (HDL), total cholesterol (CHOL) , Serum total testosterone (TT) and brachial artery-mediated flow mediated dilation (FMD) were not significantly different between the two groups (P> 0.05). The IIEF-5 scores of group B and C The difference was not statistically significant (P> 0.05). Four years later, the IIEF-5 score and FMD were measured again and compared. Results Four years after follow-up, there were 2 cases in group A, 5 in group B and 8 in group C. After 4 years follow-up, there was no significant difference in other indexes between A and B groups except for IIEF-5 scores (P> 0.05). The MAP, FPG, HDL, IIEF-5 scores and FMD (P <0.05). There was significant difference in MAP, HDL, IIEF-5 score and FMD between group B and group C (P <0.05). Conclusion NPT can reflect the functional status of vascular endothelial cells to a certain degree, which may be more sensitive than the value of FMD. Simple and noninvasive, NPT can be used as one of the reference indicators for early warning of endothelial dysfunction.