Kugonana kwa Amuna Kapena Akazi Achikulire (2014)

MAFUNSO: Phunziro lina likuwonetsa zovuta za ED ED mwa amuna:

Kufala kwa ED mwa amuna ndi 40-51 zaka kunali 58.6%

Ochita kafukufuku sanafotokoze bwino, osati kungoona kuti ED ED akukwera ndi anyamata. Mofanana ndi kafukufuku wammbuyo, ofufuza sanafunse za kugwiritsira ntchito zolaula pa intaneti.

Kuchokera pa phunziro:

Komabe, tinapezanso kusiyana kwakukulu pakati pa anthuwa. Kufala kwa ED mwa amuna omwe ali ndi 40-51 zaka anali 58.6%, zomwe zikuwoneka zosiyana ndi zomwe zapangidwe kafukufuku wa epidemiological (kuyambira 2% mpaka 39% mwa amuna pakati pa zaka za 40 ndi zaka 50) [22]. Tiye akukula kwambiri ku ED mu zaka 40-51 zaka zingathe kufotokozedwa monga izi: choyamba, Umboni wochulukirapo m'zaka zaposachedwapa wasonyeza kuti chiwerengero cha ED chikuwonjezeka kwambiri mwa anyamata aang'ono komanso apakati [23], [24]; Kachiwiri, kuchuluka kwa mild ED (53.5% mwa onse, osasonyezedwe mu zotsatira) zomwe zikupezeka m'gululi, lomwe nthawi zambiri limanyalanyazidwa m'zochitika zachipatala [25]; Chachitatu, chikhalidwe cha chikhalidwe cha chiChina ndi chikhalidwe cha anthu chikhoza kuchititsa chiwerengero chapamwamba cha ED psychojeni chikupezeka mwa amuna akuluakulu [26], pamene ma IIEF-5 sizimaphatikizapo maganizo ED [26], [27]. Tapa panalibe mgwirizano wofunikira pakati pa ED, matenda a dyslipidemia ndi moyo,

Apanso, iwo sapereka ndondomeko yabwino, kupatulapo kuwonetsa kuti ED zowonongeka zikukwera mwa anyamata. Chifukwa chachiwiri (ED wochepetsedwa pa chidziwitso chachipatala) sizowona ngati maphunziro ambiri apitalo anali okhudzana ndi chiwerengero cha anthu ndipo anaphatikizapo ED. The shocker ndikuti ED sanali kugwirizana ndi moyo moyo kapena mayeso a magazi.

Lofalitsidwa: March 25, 2014 DOI: 10.1371 / journal.pone.0092794

Yan-Ping Huang, Bin Chen makalata, Ping Ping, Hong-Xiang Wang, Kai Hu, Hao Yang, Tao Zhang, Tan Feng, Yan Jin, Yin-Fa Han, Yi-Xin Wang, Yi-Ran Huang

Kudalirika

Zolinga

Kufufuza ntchito ya erectile pakati pa amuna akuluakulu komanso akuluakulu omwe ali ndi chikhalidwe cha abambo ndikuwerenganso zifukwa zawo zenizeni.

Nkhani ndi Njira

Amuna omwe ankachita zachiwerewere nthawi zonse (kugonana nthawi zambiri nthawiXXUM pa nthawi) ankagawidwa kukhala olepheretsa erectile (ED), moyenera mpaka ku ED komanso osakhala ED malinga ndi International Index of Erectile Function-1, ndi amuna osagonana Kuyesera kwa miyezi ingapo ya 5 kunatanthauzidwa kukhala ndi chikhalidwe chokhalira. Zowonongeka zomwe zimagwirizanitsidwa ndi ED zinasonkhanitsidwa mu chitsanzo cha amuna a 6 achi China omwe ali ndi zaka 1,531 mpaka zaka 40, ndipo zifukwa zowonetsera zokhudzana ndi chikhalidwe chawo zinalembedwa m'gulu la asexual pawokha. Kuwerengera kuyerekezera ndi zitsanzo zamagulu zowonongeka zinachitidwa pakati pa magulu awa.

Results

Kuwonjezeka kwa chiwerengero cha ED ndi chikhalidwe chawo chinali 49.9% ndi 37.2%. Gulu la anthu omwe ali ndi chikhalidwe cha anthu omwe ali ndi chikhalidwe cha anthu omwe ali ndi chikhalidwe cha abambo omwe ali ndi zifukwa zoopsa kwambiri kuposa gulu la ED limakhala lachikulire (zaka = 65, kusiyana kwa mgwirizano (OR) 17.69 ndi (Vs.) 7.19), shuga (zopanda pake OR: 2.40 Vs 2.36) ndi kuthamanga kwa magazi (zopanda pake OR: 1.78 Vs. 1.72). Zifukwa zenizeni zokhudzana ndi kugonana ndi "Erectile difficulty" (52.9%), "osasamala za kugonana" (53.5%) "," palibe chifukwa choyenera kugonana pa nthawi ino "(47.7%)," nkhawa yaikulu " (44.4%), "kutopa kwakukulu" (26.3%) ndi "maliseche" (26.9%).

Mawuwo

Amuna omwe ali ndi moyo wa asexual amakhala ndi zifukwa zapamwamba za ED kusiyana ndi amuna omwe ali ochepa kwambiri mpaka ED. Ambiri mwa chikhalidwe chimenechi amatha kukhala ndi ED, ngakhale zifukwa zokhudzana ndi kugonana kwachilendo kwachilendo kumakhudzanso malingaliro ndi zofuna zogonana, kugonana ndi chiwerewere.

Chiwerengerochi

Ndemanga: Huang YP, Chen B, Ping P, Wang HX, Hu K, et al. (2014) Kugonana kwa Amuna Kapena Akazi Achikulire. PLoS ONE 9 (3): e92794. yani: 10.1371 / journal.pone.0092794

Editor: Alice YW Chang, Hospital ya Kaohsiung Chang Gung Memorial, Taiwan

Zilandiridwa: October 30, 2013; Zavomerezedwa: February 26, 2014; Lofalitsidwa: March 25, 2014

Copyright: © 2014 Huang et al. Ichi ndi nkhani yotseguka yolumikizidwa pansi pa mawu a Chilolezo cha Creative Commons Licribution, zomwe zimaloleza ntchito, kugawidwa, ndi kubwezeretsa mwachinthu chilichonse, kupatsa wolemba woyambirira ndi chitsimikizo.

Ngongole: Phunziroli linalipidwa ndi thandizo la National Natural Science Foundation ku China (No. 81270741). Komiti ya sayansi ndi zamakono Commission of Shanghai Municipality Project (No. 08411951700). Ogulitsawo analibe gawo pa kupanga maphunzilo, kusonkhanitsa deta ndi kusanthula, chisankho chofalitsa, kapena kukonzekera malembawo.

Zofuna zokakamiza: Olembawo adanena kuti palibe zotsutsana.

Introduction

Ndi chitukuko cha anthu komanso ukalamba, mankhwala ndi ntchito zokhudzana ndi kugonana zikuchulukira, ndipo akuluakulu ndi achikulire ndi omwe amawunikira kwambiri pakufufuza ndi kuchiza mavuto a kugonana. Erectile dysfunction (ED) ndi vuto lalikulu la kugonana lomwe likukambidwa ndi maphunziro ochulukirapo padziko lonse lapansi, komabe pali malire ochepa omwe angakhale osiyana ndi ED m'maganizo ndi thupi. Mosiyana ndi chikhalidwe chosakhalitsa cha chikhalidwe cha azimayi omwe akuvutitsa anthu ozungulira 2-3% mwa amuna ndipo osatanthauzira kuti alibe vuto [1], [2], chikhalidwe cha abambo angatanthauzidwe ngati malo osakhalitsa kapena osasinthika pakati pa amuna akuluakulu komanso akuluakulu omwe anali ndi chiwerewere chogonana asanayambe kugonana koma tsopano ali ndi gawo losafuna kugonana. Kawirikawiri, akatswiri a zachipatala amaganiza kuti chikhalidwe chogonana chimagwirizana ndi zinthu zakuthupi, chipembedzo, okondana ndi amuna kapena akazi okhaokha, ndipo amalephera kufufuza amuna omwe akugonana ndi amuna okhaokha, omwe sagonana ndi amuna kapena akazi okhaokha kwa nthawi yayitali, pogwiritsa ntchito Index Index wa Erectile Function (IIEF) kuti adziwe ED. Ngakhale kuti palibe ndondomeko yoyenera yowunika zowonongeka, momwe mungatsimikizire ntchito yeniyeni ya erectile ndi kufufuza zifukwa zenizeni zokhudzana ndi chikhalidwe cha anthu m'gulu lino ndizofunikira kwambiri. Koma mpaka lero, palibe deta yolongosoka, yowimira komanso yowunikira anthu yomwe ilipo kuti athandize madokotala kumvetsetsa momwe chikhalidwe chimakhalira. Shanghai anali kutsogolera pa ukalamba ndipo adakhala malo oyambirira okhala ndi anthu akale ku China. Chiwerengero cha anthu pa 65 chidzafika pachimake cha mamiliyoni anayi m'chaka cha 2025, ndiyeno kudzatenga 29% ya chiŵerengero chonse [3]. Motero anthu okalamba ku Shanghai akhoza kuonedwa kuti akuimira dziko lonse, ndipo amuna akhoza kukhala chitsanzo chabwino kwambiri chophunzira kugonana kosayenera. Cholinga cha phunziroli lopangidwa ndi anthu ambiri chinali kutsimikizira ntchito ya erectile pakati pa amuna akuluakulu komanso akuluakulu omwe ali ndi chikhalidwe chokhalira ndi abambo poyerekeza ndi chikhalidwe cha EDC komanso osakhala ED monga momwe anafotokozera zachipatala, zochitika zamakono, zamaganizo ndi zokhudzana ndi moyo wa moyo ndikupitiriza kufufuza zifukwa zenizeni zokhudzana ndi chikhalidwe cha anthu.

Zida ndi njira

Ophunzira Ophunzira

Kafukufukuyu adafufuzira za kugonana ndi chikhalidwe chaumoyo pakati pa amuna akuluakulu komanso akuluakulu kuyambira 40 kufikira zaka za 80. Midzi makumi awiri ndi iwili idali ngati midzi ya m'tawuni, kunja kwa midzi ndi madera akumidzi ndi a epidemiologists. Mizinda isanu ndi iŵiri idatsimikiziridwa kuti ifufuzidwe ndi njira ya stratified random sampling method. Otsatira ochokera kumidzi yosankhidwa mosavuta anaphatikizidwa ndi zojambula. Pa nthawi yofufuza (kuyambira 2008 mpaka 2011), amuna omwe anali ndi luso lodzikonda ndi kukhala mumzinda kwa zaka zoposa chaka adayenera kukafunsidwa. Anthu omwe anali ndi matenda oyamba msinkhu komanso / kapena matenda oopsa, matenda aakulu (mwachitsanzo matenda aakulu a mtima ndi / kapena matenda a matenda aumphawi, vuto lalikulu la chiwindi ndi / kapena chiwopsezo cha chiwerewere) ndi kugonana amuna kapena akazi okhaokha kapena amuna kapena akazi okhaokha, sanathenso kuwonetsetsa kuti akuyenerera. Matenda onsewa adatsimikiziridwa ndi ndondomeko yayekha, ndondomeko ya mbiri yachipatala ndi kuyankhulana. Ofufuza a 1,720 omwe adayenera, 1,591 adamaliza ntchito yoyambira pakhomo. Pa 1,591 yapachiyambi atayankha kafukufuku wapansi, 60 sanasankhidwe ngati deta yosagwirizana kapena yosakwanira, yomwe inasiyitsa amuna a 1,531 kukhala oyenera kuwerengetsera.

Njira Zogwiritsidwa Ntchito

Pulogalamu yachitukuko inakhazikitsidwa malinga ndi chitsanzo cha Massachusetts Male Aging Study [4]. Mwachidule, katswiri wodziwa ntchito kumunda amafika pa phunziro lililonse ku Community Service Center kapena kunyumba yake malinga ndi kafukufuku wovomerezeka wopanga ntchito yaikulu [5], chiwerengero cha anthu, chiwerengero cha mafunso okhudzana ndi umoyo komanso kugonana, ndikupeza zitsanzo za magazi. Phunziroli linalandira chivomerezo cha bungwe la kafukufuku (Renji Hospital, Shanghai.) RJLS2008175), ndipo chilolezo chodziwitsidwa chinaperekedwa ndi ophunzira onse. Deta yonse yosonkhanitsidwa idasindikizidwa mu deta yosungidwa pogwiritsira ntchito ACCESS system kuphatikizapo ntchito yogwiritsira ntchito, yomwe ingapezeke mu Science and Technology Commission ya Shanghai ndi Shanghai Institute of Andrology.

Mitundu itatu ya kuthamanga kwa magazi inapezedwa. Thupi la misala ya thupi (BMI) linkawerengedwa ngati kulemera kwa kilogalamu yomwe inagawanika ndi kutalika kwa mamita awiri ndi kugawa ntchito pogwiritsa ntchito gulu la World Health Organization (WHO) [6]: kunenepa kwambiri (≥25 kg / m2) kapena ayi (<25 kg / m2). Miyeso yozungulira m'chiuno (WC) idagwiritsidwa ntchito ngati njira yodziwika bwino, ndikugawika m'magulu awiri: kunenepa kwambiri (≥90 cm) kapena ayi (<90 cm)) [7].

Ponena za kuunika kwa chiwerewere, mafunso okhudzana ndi kugonana adaperekedwa ku phunziro lililonse kuti akwaniritsidwe payekha. M'ndondomeko yoyamba ya kugonana yomwe anthu adziyika okha m'magulu awiri: palibe kugonana kapena kugonana m'miyezi yapitayi ya 6. Fomu ya 5 ya International Index ya Erectile Function (IIEF-5) idaperekedwa kwa anthu omwe ali ndi chizoloŵezi chogonana ≥1 nthawi pamwezi m'miyezi ya 6 yapitalo, ndipo adagawidwa m'magulu atatu: osakhala ED (IIEF-5≥22), mild ED (21≥IIEF-5≥12) komanso yochepa mpaka ED (11≥IIEF-5≥5). Otsutsana opanda kugonana pofuna kuyesa miyezi iwiri ya 6 adatanthauzidwa kuti ali ndi chikhalidwe cha abambo. Zomwe zimakhudzana ndi zokhudzana ndi kugonana, kuphatikizapo mwamuna kapena mkazi mnzanu ("wosakwatira, wamasiye, wosudzulana kapena wopatukana" ndi "kugonana kosayenera"), kugonana ("osasamala za kugonana"), mavuto a erectile ("erectile difficulty"), kugonana malingaliro ("sichifunikiranso kugonana pazaka zino"), chikhalidwe cha moyo ndi moyo ("nkhawa yaikulu", "kutopa kwakukulu" ndi "kukhutira moyo wokhutira") ndi maliseche ("yachibadwa masturbatory erection" ndi "yofooka masturbatory erection" ), adasonkhanitsidwa payekha payekha. Potsirizira pake, kufotokoza zifukwa zokhudzana ndi chikhalidwe cha abambo zinasungidwa kuchokera kuzomwe zinasonkhanitsidwa za zokambirana.

Deta kuchokera kuyankhulana koyambirira idagwiritsidwa ntchito kuti ione momwe moyo umakhudzira chidwi. Ophunzirawo anafunsidwa kuti azitha kuchita masewera olimbitsa thupi m'zaka zapitazi za 5 ("nthawi zonse" amatanthauzidwa ngati kamodzi pa sabata, kwa miyezi yambiri ya 3) [8]. Omwe amamwa mowa mwauchizolowezi amawerengedwa ndi kudzikonda okha pogwiritsa ntchito Khavari ndi Farber [9]. Kusuta kwa utsi wa ndudu kunatsimikiziridwa kudzera pa kujambula kwawekha, ndipo osuta panopa akufotokozedwa ngati akusuta fodya pa nthawi ya kafukufuku ndipo akusuta fodya kuposa 100 m'moyo wawo wonse [10]. Kumwa kumwa tiyi kunayesedwa kudzera pafunso lafupipafupi la zaka zapitazo za 5 ndipo zimagawidwa m'matope ("nthawi zonse" amatchulidwa kamodzi pa tsiku, kwa zaka zoposa 1 mosalekeza).

Pofuna kutsimikizira izi zokhudzana ndi matendawa, tinagwiritsa ntchito njira zosiyanasiyana kuphatikizapo ndondomeko ya zachipatala, ndondomeko ya kafukufuku wamakono, mafunso okhudza telefoni, kapena mafunso owonjezera. Kuthamanga kwa mitsempha pamsinkhu woyambira kunasonyezedwa ngati chimodzi kapena zingapo mwazifukwa izi zinakwaniritsidwa: 1) nkhaniyi inanenedwa kuti imagwiritsa ntchito mankhwala ophera antihypertensive; 2) mankhwalawa ndi systolic blood pressure =140 mmHg kapena diastolic magazi =90 mmHg [11]. Dyslipidemia imatanthauzidwa ngati seramu wambiri cholesterol =5.72 mmol / L; ndi / kapena triglycerides =1.70 mmol / L; ndi / kapena otsika kwambiri lipoprotein cholesterol =3.64 mmol / L; ndi / kapena ntchito ya kuchepetsa mankhwala. Matenda a shuga amatanthauzidwa ngati kusala magazi m'magazi = 7.0 mmol / L ndi / kapena kugwiritsa ntchito mankhwala oletsa shuga. Pogwiritsa ntchito bungwe la National Chronicle of Health Chronic Prostatitis Symptom Index (NIH-CPSI), chizindikiro cha prostatitis (PLS) chimatanthawuzira kukhala ndi zizindikiro zochepa za m'makina (LUTS), kapena / ndi zowawa komanso / kapena kupweteka kwa ejaculatory kapena vuto [12]. Mapulogalamu a International prostatic (IPSS), kafukufuku wamakono a digito (DRE), mbiri yachipatala ya ultrasound ndi kulandira mankhwala oletsa antirojeni anagwiritsidwa ntchito kuti adziwe molondola za bongo prostatic hyperplasia (BPH).

Ophunzira onse anatha bwinobwino ntchito yophunzitsa yomwe imawatsogolera ku zolinga za phunziroli ndi zipangizo zomwe zimagwiritsidwa ntchito. Pulogalamu imodzi yosala kudya magazi imatengedwa kuti ikhale ndi shuga (kuyesedwa pogwiritsa ntchito njira yosinthidwa ya hexokinase enzymatic method) ndi njira zoyesera zamadzimadzi (zomwe zimagwiritsidwa ntchito poyesa enzymatically pogwiritsa ntchito zizindikiro zomwe zimagulitsidwa malonda) [13]. Miyi iwiri yambiri ya osalima magazi sampuli idakonzedwa chifukwa cha mayeso a mahomoni [14], [15], [16] komanso prostate specific antigen (TPSA) [17], motsatira. Mayeso onse a magazi anachitidwa ku chipatala chachipatala (Renji Hospital, Shanghai, China).

Chiwerengero cha Kusanthula

Otsatira onse adagawidwa mu magulu anayi a zaka zotsatizana malinga ndi kufalikira kwa zaka zomwe anafufuzidwa (40-51, 52-59, 60-64, ndi 65-80). Kugonana kunagawidwa m'magulu anayi: osakhala ED, wofatsa ED, wochepetsera ku ED komanso chikhalidwe cha abambo. Njira imodzi ya ANOVA (deta inagwirizana ndi kufalitsa kwabwino), Kruskal-Wallis (deta inakumana ndi zosawerengeka zosagwiritsidwa ntchito) ndi mayeso a Chi-square (ndondomeko deta) zinagwiritsidwa ntchito poyerekeza pakati pa magulu anayi pazogwirizana zonse, ndipo kukonza kwa Bonferroni kunagwiritsidwa ntchito kuthana zofuna zowonetsera mowirikiza. Potsirizira pake, ma multivariate opress models amafufuza ngati chikhalidwe choyambirira chinakhazikitsidwa, makhalidwe ochiritsira komanso okhudzana ndi moyo amakhala ogwirizana ndi chiwerewere. Mitundu yopitilira inaperekedwa ngati zowona ± kutayika kwapadera (SD) kapena wapakatikati (zochepa-maximum). Chiwerengero P<0.05 imadziwika kuti ikuwonetsa kusiyanasiyana kwakatikati pakati pamagulu. Kusanthula konse kwa ziwerengero kunachitika pogwiritsa ntchito SPSS13.0 (SPSS Inc., Chicago, Illinois, USA).

Results

Ofufuza a 1,720, tinalandira mayankho ochokera ku 1,591 maphunziro (92.5 peresenti) ndi kufufuza zitsanzo kuchokera ku 1,531 maphunziro (89.0 peresenti). Kuwerengeka kwa zaka zosiyana zaka khumi ndi makumi asanu ndi atatu (12.9-40), 51% (22.6-52), 59% (28.0-60) ndi 64% (36.4-65), motsatira. Chiwerengero cha ED ndi chikhalidwe chawo chinali 80% (49.9 / 765) ndi 1,531% (37.2 / 569), motsatira. Kugawidwa kwa matenda aakulu ndi chiwerewere pakati pa magulu a zaka zikuwonetsedwa Chithunzi 1. Zifukwa zenizeni zokhudzana ndi kugonana, kuphatikizapo zifukwa zikuluzikulu "osasamala za kugonana" (53.5%), "vuto la erectile" (52.9%), "palibe chifukwa choyenera kugonana pa nthawi ino" (47.7%), "woopsa kusokonezeka "(44.4%) ndi" masturbatory erection "(26.9%), mwachidule Chithunzi 2.

thumbnail Utsogoleri

Chithunzi 1. Kugawidwa kwa matenda aakulu ndi chiwerewere pakati pa magulu.

onetsani: 10.1371 / journal.pone.0092794.g001

thumbnail Utsogoleri

Chithunzi 2. Zifukwa zenizeni zokhudzana ndi chiwerewere pakati pa anthu osagonana.

onetsani: 10.1371 / journal.pone.0092794.g002

Gulu 1 mwachidule kusiyana kwa zifukwa zoopsya zogwirizana ndi ED pakati pa magulu anayi. Chiwerengero cha anthu omwe anali achikulire anali okalamba, kuthamanga kwa magazi, FBG yapamwamba, serum creatinine ndi TPSA; ndipo anapereka chiwopsezo chokwanira cha shuga ndi matenda oopsa.

thumbnail Utsogoleri

Gulu 1. Zizindikiro za chiwerengero cha anthu omwe akugwira nawo ntchito motsatira ndondomeko ya IIEF-5.

onetsani: 10.1371 / journal.pone.0092794.t001

Gulu 2 anasonyezanso mgwirizano pakati pa chiwerewere ndi zinthu zoopsa za ED. Pogwiritsira ntchito kugwiritsidwa ntchito, tinapeza mgwirizano wabwino pakati pa ED ndi zokalamba (zofanana chiwerengero (OR) = 8.01, 95% CI: 3.62-17.71; P<0.001), matenda ashuga (OR = 2.36, 95% CI: 1.16-4.80; P = 0.02), kuthamanga kwa magazi (OR = 1.72, 95% CI: 1.07-2.79; P = 0.03), BPH (OR = 3.58, 95% CI: 1.55-8.25; P = 0.03) ndi PLS (OR = 5.88, 95% CI: 1.20-28.79; P = 0.03); ndi mgwirizano wabwino pakati pa chikhalidwe cha ukalamba ndi ukalamba (OR = 18.49, 95% CI: 10.34-33.05; P<0.001), matenda ashuga (OR = 2.40, 95% CI: 1.36-4.25; P = 0.003) ndi kuthamanga kwa magazi (OR = 1.78; 95% CI: 1.25-2.55; P = 0.002).

thumbnail Utsogoleri

Gulu 2. Gulu la Bivariate ndi multivariate la zotsatirapo ndi ntchito yogonana.

onetsani: 10.1371 / journal.pone.0092794.t002

Kukambirana

Zomwe tapeza, zochokera ku deta yochokera ku Shanghai, zimasonyeza kuti ambiri a zaka zapakati ndi akuluakulu amakumana ndi mavuto a kugonana, komanso, anthu ochulukirapo amasonyeza kuti akugonana. Amuna omwe ali ndi chikhalidwe cha abambo anali ndi zifukwa zazikulu zowonjezereka kuposa momwe anthu ambiri akuchitira ED komanso zifukwa zambiri zokhudzana ndi umoyo wawo wachisanu ndi chiwiri zinkasokonezeka ndi erectile.

Zowonjezereka ndi zoopsa zomwe zimachitika ka ED mu phunziro lathu zinkalimbikitsa kafukufuku wakale m'mayiko a Asia ndi azungu [18], [19], [20], [21]. Zinthu zowonongeka za ED zikuphatikizapo ukalamba, shuga, matenda oopsa, BPH ndi PLS, ndi ukalamba unali wodziimira yekha. Komabe, tinapezanso kusiyana kwakukulu pakati pa anthuwa. Kufala kwa ED mwa amuna omwe ali ndi 40-51 zaka anali 58.6%, zomwe zikuwoneka zosiyana ndi zomwe zapangidwe kafukufuku wa epidemiological (kuyambira 2% mpaka 39% mwa amuna pakati pa zaka za 40 ndi zaka 50) [22]. Kukula kwa ED m'zaka za zaka 40-51 kungathe kufotokozedwa monga izi: choyamba, umboni wochulukirapo m'zaka zaposachedwapa wasonyeza kuti chiwerengero cha ED chikuwonjezeka kwambiri mwa anyamata aang'ono ndi apakatikati [23], [24]; Kachiwiri, kuchuluka kwa mild ED (53.5% mwa onse, osasonyezedwe mu zotsatira) zomwe zikupezeka m'gululi, lomwe nthawi zambiri limanyalanyazidwa m'zochitika zachipatala [25]; Chachitatu, chikhalidwe cha chikhalidwe cha chiChina ndi chikhalidwe cha anthu chikhoza kuchititsa chiwerengero chapamwamba cha ED psychojeni chikupezeka mwa amuna akuluakulu [26], pamene ma IIEF-5 sizimaphatikizapo maganizo ED [26], [27]. Panalibe mgwirizano wofunika pakati pa ED, dyslipidemia ndi moyo, zomwe zikhoza kusiyana ndi deta ya Italy yofufuza zomwe odwala ali ndi matenda a dyslipidemia [28] kapena / komanso miyambo yoipa [29], [30] anali ndi chiopsezo chachikulu chokhazikitsa ED. Zotsatira zosagwirizana izi zingachokere ku kusiyana kwa chiwerengero cha anthu. Smith ndi al. [31] anapeza kuti panalibe mgwirizano pakati pa chiwerengero cha IIEF-15 kapena kulemera kwa ED ndi serum cholesterol ndi magulu a triglyceride, ndi Hall et al [32] apezanso kuti kulibe ubale wabwino pakati pa hyperlipidemia osatengera ndi ED mumitundu yama multivariate. M'maphunziro athu, maphunziro ambiri anali okalamba (64.5%> zaka 60) ndipo adadwala matenda amisili, motero kudwala kwawo kudzawalimbikitsa kuti asinthe moyo wawo (mwachitsanzo, kusintha kwa zakudya ndi machitidwe azolimbitsa thupi), omwe itha kupindulitsa kuwongolera kwawo kwa dyslipidemia ndi kunenepa kwambiri. Koma, mbali inayo, izi zikusonyeza kuti ED m'gulu lino atha kukhudzidwa kwambiri ndi matenda amachitidwe kuposa momwe amakhalira moyo.

Kutsatsa kwa IIEF (kapena IIEF-5) kumagwiritsidwa ntchito kwambiri pofufuza ntchito ya erectile [33], [34]. Komabe, funsoli, osaganizira za amuna omwe alibe "kugonana m'masabata omalizira a 4", ndi ochepa poyesa kufotokoza za chikhalidwe cha abambo omwe akufotokozedwa pano kuti alibe kugonana kwa miyezi yoposa 6. Popeza palibe ndondomeko yeniyeni yowunika zokhudzana ndi chikhalidwe cha anthu m'madera omwe ali ndi chithandizo chamankhwala, maphunziro omwe ali ndi chikhalidwe cha abambo nthawi zambiri amachotsedwa pamaphunziro ambiri. Komabe, yankho la funsoli ndi lofunika kwambiri chifukwa pali anthu ambiri omwe ali osakhalitsa, omwe ali okalamba [35], [36]. Mu phunziro lathu, 37.2% a anthu a zaka zapakati ndi okalamba anawonetsa chikhalidwe cha abambo, motero kusonyeza kuti kusanthula gawoli sikunganyalanyazedwe. Pofuna kufotokoza zochitika zosamveka za erectile ntchito (yomaliza ED kapena ntchito yeniyeni ya erectile) m'gulu la anthu omwe ali ndi chikhalidwe cha abambo, ife tinkayerekezera chikhalidwe cha abambo ndi zovuta ku ED komanso zosakhala ED chifukwa cha zoopsa za ED. Zosintha zoopsa za 60-64 zaka ndi zaka 65-80 mwa anthu omwe anafunsidwa ndi chikhalidwe cha abambo anali apamwamba kwambiri kuposa gulu lomwe lili ndi EDE ndi 2.5 fold ndi 2.2 fold. Komanso, ngozi za matenda a shuga ndi matenda oopsa kwambiri mwa amuna omwe ali ndi chikhalidwe cha abambo anali apamwamba kusiyana ndi amuna ovuta ED. Zotsatirazi zikusonyeza kuti ambiri omwe ali ndi chikhalidwe chokhala ndi chikhalidwe chawo akhoza kukhala okhudzana ndi ED okwanira, zomwe zimamveka chifukwa chakuti amuna ambiri omwe ali ndi chikhalidwe chawo sakhala okhoza kugonana.

Poyesera kutsimikizira zomwe takambiranazi, ife tonse tinkasonkhanitsa zifukwa zathu zokhudzana ndi chigololo mwa amuna amenewo popanda kugonana. Zomwe takambirana pazofukufuku wathu zasonyeza kuti 52.9% ya amuna omwe ali m'gulu la anthu omwe ali ndi chikhalidwe cha anthu osiyana ndi amtunduwu amawoneka kuti ndi "vuto la erectile" chifukwa chachikulu cha izi zokhudzana ndi chikhalidwe chawo, zomwe zinkatsimikizira ndondomeko yomwe tatchulayi mwachindunji. Kuwonjezera apo, zodandaula za "kupanikizika kwambiri" (44.4%), "kutopa kwakukulu" (26.3%), "kugonana kosayenera" (4.4%) ndi "kukhutira moyo wathanzi" (3.0%), zomwe zimaimira chikhalidwe, maganizo ndi thupi kupsinjika kumayambitsa mavuto aakulu pa kugonana ndi kukonzedwa [37], [38], ndizinso zomwe zinapangitsa kuti chiwerengero cha abambo chisamalidwe. Zotsatirazi zafotokozedwa mwachigawo chifukwa chake amuna ambiri omwe ali ndi chikhalidwe cha abusa anavutika ndi vuto la erectile. Tinawona kuti anthu ambiri omwe ali ndi chikhalidwe cha abambo omwe saganizira kuti "samasamala za kugonana" (53.5%) ndi "palibe chifukwa chogonana pa nthawi ino" (47.7%) ndi zifukwa ziŵiri zikuluzikulu zokhudzana ndi chigololo, ndipo zikuwoneka kuti amuna kupereka zifukwa izi kungakhale ndi ntchito yokhala erectile. Ndipotu, chodabwitsachi chinali ndi mbali ziwiri: malingaliro okhudzana ndi kugonana komanso kusagonana. Monga momwe amuna ambiri omwe ali ndi chikhalidwe cha asexual anali okwatirana kapena anali ndi moyo wapadera wogonana, chikhalidwe chawo chachisanu ndi chiwiri pano n'chosiyana ndi chikhalidwe chokhazikika chachisanu ndi chiwiri chomwe sichitha kugonana ndi kusagwirizana chifukwa cha zikhulupiriro zaumwini kapena zachipembedzo kapena / kapena kugonana [39]. Motero chifukwa chachikulu chosiyanitsira kugonana kungakhale kudetsa nkhaŵa kuti zochitika zogonana zingawononge moyo wawo wochulukirapo ndi kuwonjezereka. Kuperewera kwa kugonana kungakhale kofanana ndi ukalamba (kutanthauza zaka 65.70 ± 8.20), testosterone yochepa (poyerekeza ndi osakhala ED) ndikutsata matenda aakulu, omwe akugwirizana ndi deta ku European Male Aging Study (EMAS) [40]. Kupweteka kwa tesumsterone ya serum kungapangitse kuti pang'onopang'ono kutayika kwa libido [41], ndi kusowa kwa testosterone ya seramu kungapangitse kusokonekera kwa erectile ndi kuwononga vasodilation ya penile arterioles ndi cavernous sinusoids [42]. Choncho, malingaliro osiyana ogonana ndi chilakolako chogonana chogonana chinagwirizanitsidwa ndi zifukwa zoopsya za ED komanso.

Amuna omwe ali ndi vuto lokhalira limodzi ndi chiwerewere amatha kunena kuti akhalabe ndi ntchito yowoneka ngati erectile ngakhale atayesa kugonana. Komabe, tinapeza kuti anthu ochepa omwe ali ndi chikhalidwe cha asexual, "osakwatira, amasiye, osudzulana kapena olekanitsidwa" (4.3%) monga zifukwa zokhudzana ndi chikhalidwe chawo. Ngakhale kuti pafupifupi anthu mmodzi mwa anthu anayi aliwonse omwe ali ndi zaka zam'mbuyomu, amawauza kuti ali ndi vutoli, koma 35.3% mwa iwo (9.5% m'zinthu zonse) amawoneka kuti ali ndi masewera olimbitsa thupi. Mwachidule, ngakhale kuti zifukwa zosiyanasiyana zokhudzana ndi chikhalidwe cha abambo zinalembedwa, ambiri mwa iwo akhoza kukhala ndi vuto la erectile ndi zoopsa zake.

Phunziroli liri ndi mphamvu zingapo, kuphatikizapo magulu omwe amawunikira kuti azigwiritsa ntchito popanga ma polojekiti. Kusiyanitsa kusankhidwa kunachepetsedwa chifukwa cha kuchuluka kwakukulu koyankhidwa pa ntchito (92.5%). Chofunika kwambiri, tinkatanthauzira chikhalidwe cha chikhalidwe chachisanu ndi chiwiri ndi nkhani zenizeni ndi zowerengeka ndi zokhudzana ndi chikhalidwe cha anthu monga chigawo cholingalira. Kufufuza za chikhalidwe cha anthu omwe akukhalapo pa moyo wawo wonse kungaphatikizepo kuzinthu zolembedwa kuti palibe ndondomeko yeniyeni yowunika zokhudzana ndi zokhudzana ndi chikhalidwe cha anthu. Komabe, zoperewera za phunziro lino ziyenera kuganiziridwa kuti zimasulidwe. Mofanana ndi maphunziro ambiri ofufuza ofanana, chodetsa nkhaŵa ndi chakuti ena deta anali odzidalira, ngakhale kuti njira zoyankhulana zimavomerezedwa ngati zowona. Pofuna kuthana ndi vutoli, tinasonkhanitsa deta momwe tingathere kuti tithandizire zokhudzana ndi zotsatira. Chodetsa nkhaŵa ndikuti sitinapeze mfundo zofunikira zokhudzana ndi umoyo wabwino wa atsikana ndipo sitinayambe kufufuza ndi kufufuza momwe moyo wa chikhalidwe chokhalira moyo wautali ndi wosiyana ndi chiwerengero cha anthu omwe akukhala nawo nthawi zonse.

Pomalizira, chikhalidwe cha abambo chinali kawirikawiri pakati pa zaka zakubadwa kwa amuna achikulire, ndipo amuna omwe ali ndi vutoli anali ndi zifukwa zoopsa za ED kusiyana ndi amuna omwe ali ndi mphamvu zolimbana ndi ED. Chikhalidwe chochuluka chonchi chikhoza kukhala ndi vuto la ED, ngakhale zifukwa zokhudzana ndi chikhalidwe cha abambo zimakhudzanso malingaliro ndi zofuna za kugonana, kugonana ndi chiwerewere. Maphunziro ena amafunikira kuti apange kufufuza koyenera kuti azindikire kufalikira kwa mankhwala ndi chikhalidwe cha erectile m'magulu mwa anthu omwe ali ndi chikhalidwe cha abambo, komanso kuti azindikire ndime yotsatizana ya amuna, kuphatikizapo amuna ochulukirapo, mwachitsanzo, mpaka zaka za 18. Otsatirawo athandiziranso kufotokozera zifukwa, mpaka pano sadziwika, zomwe zingachititse anyamata kukhala osakhudzidwa ndi moyo wogonana.

Kuvomereza

Olembawo akufuna kuthokoza Pulofesa Cadavid Nestor Gonzalez-Cadavid (Dipatimenti ya Urology, UCLA School of Medicine, University of Charles Drew) kuti athandizidwe ndi zolembedwazo.

Zopereka za Wolemba

Zimalengedwa ndipo zinapanga zoyesayesa: BC YW YH. Anayesa zochitika: PP HW KH HY TF YJ TZ YH. Anasanthula deta: YH HW KH HY TF YJ TZ. Zopereka zopereka / zipangizo / zowonetsera: KH HY TF YJ TZ. Wolemba analemba: YH HW. Revising It for Intellectual Content: Bin Chen Ping Ping Hong-Xiang Wang Kai Hu Hao Yang Tan Feng Yan Jin Tao Zhang.

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