摘要
目的探究血清5-羟色胺(5-HT)、神经生长因子(NGF)水平变化与原发性早泄患者阴茎背神经选择性切除术后复发的关系。方法选择原发性早泄患者200例,均行阴茎背神经选择性切除术治疗,术后6个月根据患者是否复发分为复发组(n=23)与未复发组(n=177),比较两组患者的临床资料、血清5-HT、NGF水平,分析5-HT、NGF与中国早泄问卷调查表(CIPE-5)、国际勃起功能(IIEF-5)评分、射精潜伏期(IELT)的相关性及术后复发影响因素,并构建列线图模型评价含血清指标模型预测术后复发与实际观察的一致性,用决策曲线评价该模型的临床获益。结果复发组术后3个月血清5-HT水平、IELT、CIPE-5评分均低于未复发组,NGF水平高于未复发组(P均<0.05);原发性早泄患者术前、术后1个月、术后3个月,血清5-HT水平与CIPE-5评分、IELT呈正相关(P均<0.05),与IIEF-5评分无相关性(P均>0.05);血清NGF水平与CIPE-5评分、IELT呈负相关(P均<0.05),与IIEF-5评分无相关性(P均>0.05);术后3个月IELT、CIPE-5评分及血清5-HT、NGF水平均为原发性早泄患者术后复发的独立影响因素(P均<0.05);列线图模型预测原发性早泄患者术后复发相关因素的一致性指数为0.775(95%CI=0.674~0.802);决策曲线显示,当含血清指标的模型预测原发性早泄患者术后复发的值为0.20~0.85时,可提供附加临床获益。结论原发性早泄患者阴茎背神经选择性切除术后3个月血清5-HT水平下降、NGF水平升高,二者水平变化对预测患者术后复发有一定参考价值。
Objective To investigate the relationships between the serum 5-hydroxytryptamine(5-HT)and nerve growth factor(NGF)levels and recurrence after selective resection of the dorsal nerve of the penis in patients with primary premature ejaculation.Methods Totally 200 patients who underwent selective resection of the dorsal nerve of the penis were selected as the study subjects.Six months after surgery,they were divided into the recurrent group(n=23)and non-recurrent group(n=177)based on whether the patients had recurrence or not.The clinical data,serum levels of 5-HT and NGF were compared between two groups.The correlations between 5-HT and NGF with the Chinese Index of Premature Ejaculation-5 questionnaire(CIPE-5),International Index of Erectile Function-5(IIEF-5)score,and ejaculation latency time(IELT)were analyzed.Factors affecting postoperative recurrence were analyzed,and we constructed a nomogram model to evaluate the consistency between the postoperative recurrence predicted by model containing serum indicators and the actual observation,and used the decision curve to evaluate the clinical benefit of the model.Results The serum 5-HT level,IELT,and CIPE-5 score in the recurrent group were lower than those in the non-recurrent group at 3 months after surgery,while the NGF level was higher than that in the non-recurrent group(all P<0.05).The serum 5-HT level was positively correlated with CIPE-5 score and IELT in patients with primary premature ejaculation before surgery,1 months after surgery,and 3 months after surgery(all P<0.05),but was not related to IIEF-5 score(P>0.05);the serum NGF level was negatively correlated with CIPE-5 score and IELT(all P<0.05),but was not related to IIEF-5 score(P>0.05).IELT,CIPE-5 score,serum 5-HT,and NGF levels at 3 months after surgery were independent influencing factors for postoperative recurrence in patients with primary premature ejaculation(all P<0.05).The consistency index of the nomogram model in predicting postoperative recurrence related factors in patients with primary premature ejaculation was 0.775(95%CI=0.674-0.802).The decision curve showed that when the model containing serum indicators predicted postoperative recurrence in patients with primary premature ejaculation in the range of 0.2-0.85,it could provide additional clinical benefits.Conclusion The serum 5-HT level decreases and NGF level increases 3 months after selective resection of the dorsal penile nerve,which has certain reference value for predicting postoperative recurrence in patients with primary premature ejaculation.
作者
李鸿斌
侯琳
邢建东
冯东
樊茂宇
LI Hongbin;HOU Lin;XING Jiandong;FENG Dong;FAN Maoyu(Department of Urology,The Fifth People's Hospital of Datong City,Datong 037000,China)
出处
《山东医药》
CAS
2024年第19期30-34,共5页
Shandong Medical Journal
基金
山西省重点研发计划项目(201903D321157)。
作者简介
第一作者:李鸿斌(1977-),男,硕士研究生,副主任医师,主要研究方向为男科学。E-mail:sigun1980217@yeah.net。
