The Effect Of Penis Haemodynamics In Erectile Dysfunction Of Type 2 Diabetes

Objective: Measuring the blood flow rate of the four artery of penis to study the relationship between penis haemodynamics and type 2 diabetes erectile dysfunction(ED),we determin T and PRL at the same time to discuss the relationship between the level of hormon and erectile dysfunction of diabetes mellitus(DM),besides detect the high sensitivity C- reactive protein which can respond the damage extent of vascular endothelial cell(VEC) to analysis the association between the damage of VEC and ED of DM, then provid clinical diagnosis evidence accordingly.Method: In this study ,we select eighty-five patients who is in hospital and in endocrine division.All of them are shortage of fifty-five,not smoking,not dringking,not suffered from hypertension, coronary heart disease and the renal function is normal, moreover they did not make use of vasoactive drugs in the near future. International Index of Erectile Function (IIEF-5) for evaluation of erectile function and grading of severity of ED was completed by each subject. Erectile dysfunction was classified according to the definitions of Zhou Heng et al 5 as four groups: Group A ,no ED (22 to 25), they are 30 to 53 years old ,the mean and and standard deviation is 44.0±6.1;Group B, mild ED (18 to 21), they are 28 to 50 years old ,the mean and and standard deviation is 40.7±6.8;Group C, moderate ED (14 to 17), they are 30 to 54 years old ,the mean and and standard deviation is 44.2±6.7;Group D, severe ED (0 to13), they are 35 to 50 years old,the mean and and standard deviation is 42.0±4.9, othewise we select tweety normal adult male volunteer as comparison group R (22 to 25), they are 27 to 51 years old ,the mean and and standard deviation is 40.9±6.6.The ages of groups are matched.The diagnostic cod of diabetes mellitus is consistent with the proposition that American Diabetes Association ssuggested to modify the international reference 1980 World Health Organization in 1997.1 Every body got a number according to the order and memorized name,age and the next day seven o'clock in the morning measure their height,weight and blood pressure with an empty stomach.The next day morning they in hospital we hold their elbow vein blood with an empty stomach too. Leave 2.5ml to detect renal function(urea nitrogen, Crea and uric acid) and blood-fat(total cholesterol and triglyceride);3ml blood was centrifuged 10 minutes then gather the blood-serum and saved at -70 centi-degree for detect high sensitivity C - reactive protein(hs-CRP), androgen(T) and prolactin(PRL);Besides 2ml blood submitted to detect glycosylated hemoglobin A1c(HbA1c).2 The 7600-020 autoanalyser of HITACHI was used to detect renal function and blood-fat,the agents come from the first chemical firm in Japan;We use the high-pressure liquid method to test HbA1c,the machine D-10 comes from Americ and the agent comes from the same company;The androgen and prolactin were tested with immunochemiluminometry,the machine 2MMULITE comes from DPC of German,the agents come from the same company.3 The high sensitivity C - reactive protein(hs-CRP) testing method is enzyme-linked immunosorbent assay,the machine MK-Ascent comes from Rehberg's compony in Finland,we make sure that the whole empirical procedure is consistent with the demonstration of kit.4 The peak systolic velocity (PSV) and mean glow velocity (MV)of penis cavernosal artery and penis dorsal artery were measured with supersonic blood survey meter ES-1000SPM made in DI MEI DE company in beijing.Annotation:The blood rate of the right penis cavernosal artery memorized as PSV1 and MV1,the left as PSV2 and MV2; The blood rate of the right penis dorsal artery memorized as PSV3 and MV3,the left as PSV4 and MV4;The sum blood rat of the four artery memorized as PSV and MV.The data statistical analysised with SAS6.12.The measurement data multiple compared with multiple factor analysis of variance,if there is statistical significance between the groups then analysis advanced every two groups with Student's t-test of significance for the mean of two groups;The numeration data statistical analysised with chi-square test ,if there is a dfference then analysised with partition of chi-square .The test criterion isα=0.05,if the value of P less than 0.05 discovered that there is a statistic significance.Result: There is no statistical difference of body mass index(BMI) and glycosylated hemoglobin A1c(HbA1c) between the five groups,besides the attack rates of hypercholesteremia and hypertriglyceridemia have no statistical significance berween the groups.1 The comparation of PSV between the groups1.1 The analysis of variance showed that there are statistical significances of PSV1 and PSV2 between the groups,the value of P is small than 0.01 equal.The comparison results of groups prove that there is a difference between every two groups(P<0.05).1.2 The analysis of variance for PSV3 showed that there are statistical significances between the groups(P<0.01),the results of group comparison display that there are differences between every two groups (P<0.05) but the group A and B(P>0.05).1.3 The analysis of variance for PSV4 showed that there are statistical significances between the groups(P<0.01),the results of group comparison display that there is a different between every two groups (P<0.05) but the group B and A,C(P>0.05).1.4 The analysis of variance showed that there are statistical significances of PSV between the groups(P<0.01),the comparison results between groups prove that there are differences between every two groups(P<0.05).The means of the four artery PSV display that there is a fall tendency of PSV incident to exacerbation.2 The comparation of MV between the groups2.1 The analysis of variance for MV1 showed that there are statistical significances between the groups(P<0.01), the group comparison displayed that there is different between every two groups (P<0.05) but the group A and B,C and D(P>0.05).2.2 The analysis of variance for MV2 showed that there are statistical significances between the groups(P<0.01),the result of group comparison showed that there is no stastic significance between group R A and B,C and D also.2.3 The analysis of variance for MV3 showed that there are statistical significances between the groups(P<0.01),the result of group comparison showed that there is no stastic significance between group R A and B,C and A B also.2.4 The analysis of variance for MV4 showed that there are statistical significances between the groups(P<0.01),the result of group comparison showed that there is no stastic significance between group B and A C.2.5 The analysis of variance showed that there are statistical significances of MV between the groups(P<0.01),the comparison results between groups prove that there is difference between every two groups(P<0.05)but group A and B.The means of the four artery MV display that there is a rise tendency of MV incident to exacerbation.3 The comparation of groups for the level of hormone and hs-CRPThe analysis of variance for T showed that there is no statistical significance between the groups(P>0.05),but there are distinct stastical significances of PRL and hs-CRP between the groups(P<0.01),beside there is a transparent rise tendency of PRL and hs-CRP incident to exacerbation displayed from the means and standard deviationes.4 The correlation analysis and regression analysis for the IIEF-5 scores and the observed indexes4.1 The correlation analysis between the IIEF-5 scores and the observed indexes revealed that the scores are positive correlation with PSV,especially PSV1 PSV2 and PSV;The correlation relationship between the score and MV is negative,MV and MV1 are distinct;the coefficient correlation of IIEF-5 score and T is 0.0467,but the hypothesis test for the coefficient correlation showed that there is no stastical significance(P=0.6359>0.1);The IIEF-5 score is also negative correlated with PRL and hs-CRP.4.2 For the IIEF-5 score as dependent variable ,PSV MV T PRL and hs-CRP as argument do a regression analysis ,using the stepwise method, PSV MV and PRL all fit-into the model.Conclusion: The PSV of penis cavernosal artery and penis dorsal artery have higher accuracy for the diagnosis of DM with ED,the measurement of PSV of cavernous arteries is more sensible,the PSV falled incident to exacerbation;The MV of cavernous arteries display a rise tendency incident to exacerbation,the MV of the right cavernous atery and the sum MV are more significant,the MV of the four arteries are hyper than one centi-metre every second in the moderate ED group and the severe group,discovering that there are artery and vein functional defect at this time.There isn't a marked chage of T in the prosess of ED with DM,but the level of PRL rising incidently to exacerbation and the inflammatory reaction becomes seriously too.The multiple regression analysis showed that the descent of PSV,rising of MV and PRL are also single risk factor of ED with DM.