en سطح هورمون های جنسی و اختلال عملکرد جنسی در مردان پس از پیوند بای پس سرخرگ کرونری Original Article Original Article <strong><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">مقدمه:</span></span></span></strong> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">اختلال عملکرد جنسی یکی از شایع&shy;ترین مشکلات در مردان پس از جراحی پیوند بای&shy;پس سرخرگ کروناری (</span></span></span><span dir="LTR" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:10pt;">CABG</span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">) است. علت اختلال عملکرد جنسی در این بیماران ممکن است روحی روانی بوده و یا ارگانیک ناشی از تغییرات هورمونی باشد.</span></span></span><span style="font-size:11.0pt;"></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">: <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;">هدف، بررسی میزان بروز و نوع اختلال عملکرد جنسی و تغییر غلظت سرمی هورمون های جنسی در بیماران مرد تحت عمل </span></span></span><span dir="LTR" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:10pt;">on-pump CABG</span></span> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">بود.</span></span></span><span style="font-size:11.0pt;"></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مواد و روش&shy; ها:</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;">در این مطالعه قبل و بعد، ما 40 مرد در سنین کمتر از 70 سال را که کاندید </span></span></span><span dir="LTR" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:10pt;">on-pump CABG</span></span> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">بودند بررسی کردیم. مصاحبه&shy;ها توسط یک پزشک قبل و 12 هفته پس از جراحی در مورد تأثیر عمل بر فعالیت&shy;های جنسی آنان صورت گرفت. سطح سرمی 6 هورمون جنسی هم تعیین شد. آزمون&shy;های آماری بکار رفته برای آنالیز داده&shy; ها شامل آنالیز واریانس، آزمون مک نمار و آنالیز مربع کای بودند.</span></span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج:</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;">میانگین</span></span></span><span dir="LTR" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:11pt;">&plusmn;</span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">انحراف معیار سن بیماران 7/86</span></span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:11pt;">&plusmn;</span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">51/27 سال بود. میزان بروز اختلال عملکرد جنسی قبل از عمل (9 مورد) 22/5% و در بعد از عمل (19 مورد) 47/7% بدست آمد. انواع اختلال عملکرد جنسی شامل انزال زودرس (5% قبل، 2/5% پس از عمل)، ناتوانی جنسی (7/5% قبل، 12/5% پس از عمل) و از دست دادن میل جنسی (10% قبل، 32% پس از عمل) بود. سطح هورمون&shy; های جنسی در مجموع پس از جراحی کاهش داشت ولی تفاوت آن فقط در مورد استروژن معنی &shy;دار بود (0/02=</span></span></span><span dir="LTR" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-size:11pt;">p-value</span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">).</span></span></span><br> <strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری:</span></span></span></strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> <span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;">اختلال عملکرد جنسی و کاهش سطح سرمی هورمون&shy;های جنسی در بیماران قبل از </span></span></span></span><span style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:times new roman,serif;"><span style="font-size:10pt;">on-pump CABG</span></span></span><span dir="RTL" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;"> شایع است و اکثرا پس از عمل بدتر می&shy;شود. برای پیشگیری و درمان این اختلالات مطالعات تکمیلی پیشنهاد می&shy;</span></span></span><span dir="RTL" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">گردد</span></span></span><span dir="RTL" style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-attachment:initial;background-origin:initial;background-clip:initial;"><span style="font-family:b mitra;"><span style="font-size:11pt;">.</span></span></span> <strong>Background:</strong> Sexual dysfunction is one of the most common problems in men after coronary artery bypass graft (CABG). Etiology of sexual dysfunction in these patients may be psychological or organic due to hormonal changes.<br> <strong>Objective: </strong>The purpose was to evaluate the incidence and type of sexual dysfunction and changes in serum concentration of sex hormones in male patients undergoing on-pump CABG.<br> <strong>Materials and Methods:</strong> In this before and after study we enrolled 40 men aged less than 70 years who were candidate for on-pump CABG. Interviews were done by a physician before and 12 weeks after the operation in regard to the impact of surgery on their sexual activities. The serum levels of 6 sex hormones were also determined. The statistical tests used for data analysis included analysis of variance, McNemar&#39;s test and chi-square analysis. <strong>Results:</strong> The mean&plusmn;SD age of the patients was 51.27&plusmn;7.86 years. Incidence of sexual dysfunction was 22.5% (9 cases) before and 47.7% (19 cases) after operation. Types of sexual dysfunction were premature ejaculation (5% before, 2.5% after), impotence (7.5% before, 12.5% after) and loss of libido (10% before, 32% after). The level of sex hormones were generally decreased after operation but it was statistically significant only for estrogen (p-value=0.02).<br> <strong>Conclusion:</strong> Sexual dysfunction and reduction in serum level of sex hormones are common in patients before on-pump CABG and mostly get worse after surgery. Complementary studies are suggested for prevention and treatment of sexual dysfunction. پیوند عروق کرونری, اختلال عملکرد جنسی, هورمون های جنسی, انزال, ناتوانی جنسی Coronary artery bypass, Sexual dysfunction, Sex hormones, Ejaculation, Impotence 425 428 http://ijrm.ir/browse.php?a_code=A-10-31-80&slc_lang=en&sid=1 Seyed Khalil Forouzannia سید خلیل فروزان نیا No Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran مرکز تحقیقات قلب و عروق، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران Mohammad Hassan Abdollahi محمد حسن عبداللهی No Department of Anesthesiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران Seyedhossein Hekmatimoghaddam سید حسین حکمتی مقدم shhekmati2002@yahoo.com Yes Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran گروه علوم آزمایشگاهی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران Sadegh Ali Hassan Sayegh صادق علی حسن سایق No Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran مرکز تحقیقات قلب و عروق، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران