| Backgroud and object: Premature ejaculation(PE) is the most common disease in male ejaculation dysfunction. There are a lot of research results shows that 5-hydroxy trytamine(5-HT) as one of the important neurotransmitter in the process of ejaculation. 5-HT reduced in the central nervous system, 5-HT2 A receptor high sensitivity and low sensitivity 5-HT2 c receptors are associated with premature ejaculation. Also some research suggests that leptin can accelerate 5-HT metabolism resulting in 5-HT levels decrease in the central nervous system, regulating the ejaculation process. Furthermore, leptin may also through multiple pathways regulate ejaculation activities such as NO pathway. Whether can be measured before and after treatment serum levels of 5-HT and leptin concentration variation to assess the therapeutic efficacy of premature ejaculation, providing an objective laboratory index, riching therapy system, which is the topic for the purpose of the project.On the leptin, 5-HT and therapeutic efficacy of PE of correlation, only a small amount of research was reported abroad, and in the domestic rare literature was reported. In addition, combinations of drugs in the treatment of PE and process of computer automatic semen collection-penile erectile monitoring analysis system(WLJY-2008) of desensitization training module to assist patients behavior training related literatures have seldom been reported in domestic and foreign literatures.PE treatment effect evaluation still lacks effective laboratory indicator, therefore it is necessary to further explorating connection of 5-HT, leptin and PE treatment effect, to providing new monitoring for PE treatment effect evaluation index, which has important guiding significance for the future clinical work.Methods:1. The test group, the clinic collection of 85 patients with PE, is divided into three groups: the drug therapy group, 31 patients, are treated by sertraline hydrochloride treatment for 8 weeks; desensitization training group, 25 patients, are treated by desensitization treatment assisted process of computer automatic semen collection-penile erectile monitoring analysis system(WLJY-2008) of desensitization training modules for 8 weeks and combined therapy group, 29 patients, are treated by sertraline hydrochloride treatment during the machine auxiliary desensitization treatment for 8 weeks. The control group, 31 cases, is recruited form healthy volunteers.2. Measure all subjects intravaginal ejaculatory latency time(IELT) accurately using a stopwatch and the questionnaire scores by "Chinese patients with PE function evaluation(CIPE-5)" in the before and after treatment.3. On an empty stomach measure all subjects serum 5-HT and leptin concentrations by enzyme-linked immunosorbent after the baseline period and three ways treatment.4. The IBM SPSS 20 packets is applied to statistics and analyse the data.Results:1. 5-HT rise is significantly associated with IELT increase and CIPE-5 score rise, Pearson correlation coefficient is 0.660 and 0.821, statistically significant difference. Leptin reduce associated with elevated CIPE-5 and elevated IELT, Pearson correlation coefficient is 0.393 and 0.380, statistically significant difference. Leptin and 5-HT have moderate correlation, Pearson correlation coefficient is 0.408, statistically significant differences. After treatment, the addition of the IELT and the 5-HT increase present obvious positive correlation; and CIPE-5 is the same. However, the addition of IELT and leptin increase present obvious negative correlation,; and CIPE-5 is the same.2. The sertraline treatment group patients, in IELT, CIPE-5 score and serum concentration of 5-HT have obvious rise, and in leptin decrease significantly, tending to the healthy controls level. Desensitization training group patients in IELT, CIPE-5 score was obvious rise, and the leptin concentration was decreased, while the 5-HT concentration increased before treatment. Combined treatment group patients,in IELT, CIPE-5 score and serum 5-HT, were rising sharply, and leptin concentrations decreased obviously, which is close to the control level. In the three methods of treatment, every index variation of combination group is the largest, most approaching the healthy controls, and sertraline group take second place.3, Before treatment, in the three groups of patients fasting serum leptin levels were significantly higher than that of healthy controls, and fasting serum 5-HT level below the normal level of healthy controls.Conclusion:1. Fasting serum 5-HT concentration variation and treatment effect have obvious relevance, and leptin is the same. Namely after treatment in patients, IELT and CIPE-5 score is higher, the fasting serum 5-HT concentration the higher, the fasting serum leptin concentration lower. Fasting serum leptin concentration and serum concentration of 5-HT have certain relevance, namely, serum leptin concentration is higher, the concentration of serum levels of 5-HT the lower, presenting the negative correlations.2. Three kinds of treatment all can improve IELT and sexual satisfaction. Among them, sertraline hydrochloride+desensitization training combination scheme to improve the situation is the best; and sertraline hydrochloride solution takes second place.3. Comparing with the healthy controls, fasting serum 5-HT level of PE patients significantly lower, while fasting serum leptin level obviously higher. We can speculat that the two indicators will be good diagnostic laboratory indexes. |
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