目的 分析阴茎振动阈值测定在勃起功能障碍(ED)诊断中的应用价值,为临床判断患者ED严重程度提供参考.方法回顾性分析2021年1月—12月在郑州大学第一附属医院男科门诊就诊的257例以勃起功能下降为主诉或为伴随症状就诊患者的一般资料、阴茎勃起硬度分级评分表(EHS)得分、国际勃起功能指数问卷表-5(IIEF-5)得分及阴茎振动感觉阈值(VPT).以EHS=4分且IIEF-5≥22分者为正常组,其余为ED组,比较不同EHS评分患者VPT差异,分析IIEF-5与VPT的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估VPT对ED的诊断价值.结果 不同EHS评分患者之间阴茎VPT差异有统计学意义(P<0.05),随EHS评分降低,VPT呈升高趋势.龟头及阴茎体VPT与IIEF-5评分均呈负相关(ρ=-0.22和 ρ=-0.26,P<0.001).ED 组龟头 VPT[(4.17±1.37)V vs.(3.47±1.24)V,P=0.009]、阴茎体 VPT[(3.73±1.41)V vs.(2.99±1.14)V,P=0.003]均高于正常组.龟头VPT的ROC曲线下面积(AUC)为0.642,当截断值取3.537 V时,灵敏度为63.4%、特异度为63.6%;阴茎体VPT的AUC为0.659,当截断值取2.775 V时,灵敏度为72.3%、特异度为54.5%.结论ED患者阴茎VPT高于正常者,VPT与ED严重程度具有相关性,ED程度越重VPT值越高,阴茎VPT测定有助于临床上判断患者ED的严重程度.
Objective To analyze the application value of penile vibrating perception threshold measurement in the diagnosis of erectile dysfunction(ED)and provide reference for the seversity of ED patients.Methods The clinical data,Erectile Hardness Scale(EHS)score,International Index of Erectile Function Questionnaire-5(IIEF-5)score,and the vibrating perception threshold(VPT)of the penis of 257 patients with decreased erectile function as the main complaint or accompanying symptoms treated during Jan.and Dec.2021 were retrospectively collected and analyzed.Patients with EHS=4 and IIEF-5≥22 were classified into the normal group,and the rest into the ED group.The differences in VPT in patients with different EHS scores were compared,and the correlation between IIEF-5 and VPT was analyzed.The diagnostic value of VPT for ED was evaluated with receiver operating characteristic(ROC)curve.Results The difference in penile VPT among patients with different EHS scores was statistically significant(P<0.05).With the decrease of EHS score,VPT showed an increasing trend.Glans VPT was negatively correlated with IIEF-5 score(ρ=-0.22,P<0.001),and penile shaft VPT was also negatively correlated with IIEF-5 score(ρ=-0.26,P<0.001).The VPT of glans penis[(4.17±1.37)V vs.(3.47±1.24)V,P=0.009]and the VPT of penis body[(3.73±1.41)V vs.(2.99±1.14)V,P=0.003]in the ED group were both higher than those in the normal group.The area under the ROC curve(AUC)of the glans VPT was 0.642.When the cut-off value was 3.537 V,the sensitivity was 63.4%,and the specificity was 63.6%.The AUC of the penile shaft VPT was 0.659.When the cut-off value was 2.775 V,the sensitivity was 72.3%,with a specificity of 54.5%.Conclusion The penile VPT of ED patients is higher than that of normal ones,and there is a correlation between VPT and the severity of ED.Severe ED is associated with higher VPT.The measurement of penile VPT is helpful for the clinical diagnosis of ED patients.