【摘要】 目的 探讨彩色多普勒超声(CDUS)结合阴茎勃起硬度分级(EHS)对亚型血管性勃起功能障碍(ED)严重程度的诊断价值。方法 选取2020年4月至2021年4月浙江省丽水市中心医院收治的100例拟因ED就诊并符合纳入标准的亚型血管性ED患者作为研究对象。根据EHS标准分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级，并以此分为理想组(Ⅳ级)、轻度组(Ⅲ级)、中度组(Ⅱ级)和重度组(Ⅰ级)。采用双盲法对所有患者进行经阴茎海绵体注射血管活性药物试验(ICI),注射前列地尔约2 mL诱导阴茎勃起后行CDUS,测量阴茎海绵体动脉的血流动力学参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)和阻力指数(RI)],比较四组的血流动力学参数。结果 轻度组与中度组的PSV比较，差异无统计学意义(P>0.05);其余各组组间PSV比较，差异均具有统计学意义(P<0.05)。重度组与中度组的EDV比较，差异无统计学意义(P>0.05);其余各组组间EDV比较，差异均具有统计学意义(P<0.05)。各组组间RI比较，差异均具有统计学意义(P<0.05)。PSV与EHS呈正相关(r=0.71,P<0.05),EDV与EHS呈负相关(r=-0.80,P<0.05),RI与EHS呈正相关(r=0.83,P<0.05)。结论 CDUS结合EHS能更好地评估亚型血管性ED患者的勃起功能，PSV、EDV、RI与亚型血管性ED的严重程度相关，其中RI可以更为准确地反映血管性ED的严重程度。更多还原

【Abstract】 Objective To investigate the diagnostic value of color Doppler ultrasound(CDUS) combined with erectile hardness scale(EHS) to assess the severity of subtype vascular erectile dysfunction(ED). Methods A total of 100 patients with subtype vascular ED who were expected to receive ED treatment and met the inclusion criteria from April 2020 to April 2021 in Lishui Central Hospital were selected as study objects. According to the EHS standards, they were classified into levels Ⅰ,Ⅱ,Ⅲ and Ⅳ, and were thus divided into the ideal group(level Ⅳ), the mild group(level Ⅲ), the moderate group(level Ⅱ) and the severe group(level Ⅰ). The intracavernosal injection(ICI) test was performed in all patients by double-blind method. Hemodynamic parameters of penile cavernous arteries [peak systolic flow velocity(PSV), end-diastolic flow velocity(EDV), and resistance index(RI)] were measured by CDUS after the injection of alprostadil about 2 mL to induce penile erection, and hemodynamic parameters were compared among the four groups. Results The difference in PSV between the mild and moderate groups was not statistically significant(P>0.05), and the difference in PSV between the remaining groups was statistically significant(P<0.05). The difference in EDV between the severe and moderate groups was not statistically significant(P>0.05), and the difference in EDV between the remaining groups was statistically significant(P<0.05). The difference in RI between the groups was statistically significant(P<0.05). PSV was positively correlated with EHS(r=0.71, P<0.05), EDV was negatively correlated with EHS(r=-0.80, P<0.05), and RI was positively correlated with EHS(r=0.83, P<0.05). Conclusions CDUS combined with EHS provides a better assessment of erectile function in patients with subtype vascular ED. PSV, EDV and RI correlated with the severity of subtypes of vascular ED, with RI providing a more accurate response to the severity of vascular ED.更多还原