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目的探讨T2DM女性患者性功能障碍的特点,并分析其发生的危险因素。方法选取T2DM女性患者227例,根据是否伴女性性功能障碍(FSD)分为单纯糖尿病组(DM)组[女性性功能指数问卷(FSFI)评分≥25]144例和糖尿病FSD组(DM+FSD组,FSFI评分<25)83例,另选取同期于我院体检中心体检健康女性80名作为健康对照(NC)组。采用FSFI问卷评估各组性功能,Logistic回归分析糖尿病女性患者伴FSD的危险因素。结果 T2DM女性患者中,FSD的发生率为36.6%(83/227);与NC组比较,DM+FSD组和DM组卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(TSTO)升高,雌二醇(E2)降低(P<0.01);DM+FSD组与DM组比较,差异无统计学意义(P>0.05);与NC组比较,DM组和DM+FSD组性欲[(4.59±1.22)vs(3.76±0.90)vs(2.54±0.58)分]、性唤起[(4.81±1.00)vs(3.57±0.85)vs(2.30±0.42)分]、阴道润滑[(5.14±0.83)vs(4.46±1.32)vs(3.35±0.29)分]、性高潮[(4.02±1.25)vs(3.40±1.86)vs(2.75±0.68)分]4个维度评分及总分[(28.13±5.78)vs(24.71±6.33)vs(17.94±4.15)分]均降低(P<0.05或P<0.01)。DM+FSD组性满意度[(3.45±1.68)vs(4.94±0.93)、(4.99±0.86)分]和性疼痛[(3.55±0.50)、(4.58±0.47)vs(4.58±0.62)分]2个维度评分低于DM组和NC组(P<0.05),DM组和NC组比较,差异无统计学意义(P>0.05);Logistic回归分析显示,年龄、BMI及HbA_1c为糖尿病伴FSD的危险因素(P=0.029、0.001、0.022)。结论糖尿病FSD的发生率较高,年龄、BMI、HbA_1c是其主要危险因素。
Objective To investigate the characteristics of sexual dysfunction in female patients with T2DM and to analyze the risk factors. Methods A total of 227 patients with T2DM were enrolled in this study. One hundred and fourteen patients with diabetes mellitus (DM FSD) [FSFI score ≥25] and DM + FSD Group, FSFI score <25) 83 cases, the other selected the same period in our hospital physical examination of 80 healthy women as a healthy control group (NC). FSFI questionnaire was used to evaluate the sexual function of each group, Logistic regression analysis of risk factors for diabetic women with FSD. Results The incidence of FSD was 36.6% (83/227) in T2DM women. Compared with NC group, FSH, LH and TSTO in DM + FSD group and DM group were significantly higher than those in NC group (P <0.01). There was no significant difference between DM + FSD group and DM group (P> 0.05). Compared with NC group, the libido [( (4.81 ± 1.00) vs (3.57 ± 0.85) vs (2.30 ± 0.42) vs vaginal lubrication [(5.14 ± 0.83) vs (4.54 ± 1.22) vs (3.76 ± 0.90 vs (4.46 ± 1.32) vs (3.35 ± 0.29), orgasm (4.02 ± 1.25 vs 3.40 ± 1.86 vs 2.75 ± 0.68, respectively) vs (24.71 ± 6.33) vs (17.94 ± 4.15) points, respectively (P <0.05 or P <0.01). Satisfaction of DM + FSD group was significantly higher than that of DM + FSD group [(3.45 ± 1.68) vs (4.94 ± 0.93) vs (4.99 ± 0.86)] and sexual pain [(3.55 ± 0.50) vs (4.58 ± 0.62) There was no significant difference between DM group and NC group (P> 0.05). Logistic regression analysis showed that age, BMI and HbA_1c were the markers of diabetes with FSD Risk factors (P = 0.029, 0.001, 0.022). Conclusions The incidence of diabetic FSD is high. Age, BMI and HbA_1c are the major risk factors.