目的: 探究勃起功能障碍(erectile dysfunction，ED)患者年龄、不同激素水平及生化指标对阴茎海绵体血管功能的影响。方法: 回顾分析2020年1月至2023年8月于北京大学第三医院生殖医学中心男科进行彩色双频多普勒超声(color duplex Doppler ultrasonography，CDDU)联合阴茎海绵体注射试验(intracavernosal injection test，ICI)的ED患者的临床资料。使用SPSS 29.0建立数据库进行数据处理，采用多因素Logistic回归进行分析。结果: 共纳入700例ED患者，其中ICI结果阴性380例，阳性320例；阴茎海绵体动脉收缩期速度(peak systolic velocity，PSV) < 25 cm/s者84例，≥25 cm/s者616例；舒张末期速度(end diastolic velocity，EDV)>5 cm/s者202例，≤5 cm/s者498例；PSV和/或EDV结果异常者264例，PSV和EDV结果均正常者436例。血管性ED患者相较于非血管性ED患者雌二醇和睾酮水平更低(t=-3.546，P＜0.001；t=-2.089，P=0.037)，高血糖发生率更高(χ²=12.772，P=0.002)。动脉性ED患者相较于非动脉性ED患者年龄更大(t=3.953，P＜0.001)，高血糖发生率更高(χ²= 9.518，P=0.009)，雌二醇/睾酮比值更高(t=2.330，P=0.020)。动静脉混合性ED患者相较于均正常者的患者年龄更高(t=3.567，P＜0.001)，睾酮水平更低(t=-2.288，P =0.022)，高血糖发生率更高(χ²=12.877，P= 0.002)，雌二醇/睾酮比值更大(t=2.096，P =0.037)。多因素Logistic回归分析表明，雌二醇水平升高是血管性ED的保护因素(OR=1.009，95%CI：1.004~1.014)，葡萄糖≥7.0 mmol/L是血管性ED的危险因素(OR=0.381，95%CI：0.219~0.661)；年龄增长是动脉性ED的危险因素(OR=0.960，95%CI：0.938~0.982)；年龄增长(OR=0.976，95%CI：0.958~0.993)、葡萄糖5.6~6.9 mmol/L(OR=0.591，95%CI：0.399~0.876)是动静脉混合性ED的危险因素。结论: 高血糖和年龄增长可能使阴茎海绵体血管功能减退，而雌二醇水平升高可能对阴茎海绵体血管功能有保护作用。

Objective: To investigate the impact of age, various hormonal levels, and biochemical markers on penile cavernous body vascular function in patients with erectile dysfunction (ED). Me-thods: A retrospective analysis of clinical data from male patients with ED who underwent color duplex Doppler ultrasonography (CDDU) and intracavernosal injection test (ICI) at the Reproductive Medicine Center of Peking University Third Hospital from January 2020 to August 2023. Data were managed and processed using SPSS 29.0, and a multivariable Logistic regression analysis was conducted. Results: A total of 700 ED patients were included, with 380 showing negative ICI results and 320 positive. In the study, 84 patients had a peak systolic velocity (PSV) < 25 cm/s, while 616 had PSV≥25 cm/s; 202 patients had end-diastolic velocity (EDV)>5 cm/s, and 498 had EDV≤5 cm/s. 264 patients had abnormal PSV and/or EDV results, and 436 had normal results for both. Patients with vascular ED had significantly lower estrogen levels (t=-3.546, P < 0.001), lower testosterone levels (t=-2.089, P=0.037), and a higher rate of hyperglycemia (χ²=12.772, P=0.002) compared with those with non-vascular ED. The patients with arterial ED were older (t=3.953, P < 0.001), had a higher rate of hyperglycemia (χ²=9.518, P=0.009), and a higher estrogen/testosterone ratio (t=2.330, P=0.020) compared with those with non-arterial ED. The patients with mixed arteriovenous ED had higher age (t=3.567, P < 0.001), lower testosterone levels (t=-2.288, P=0.022), a higher rate of hyperglycemia (χ²=12.877, P=0.002), and a larger estrogen/testosterone ratio (t=2.096, P=0.037) compared with those with normal findings. Multifactorial Logistic regression analysis indicated that higher levels of estrogen were a protective factor for vascular ED (OR=1.009, 95%CI: 1.004-1.014), and glucose≥7.0 mmol/L was a risk factor (OR=0.381, 95%CI: 0.219-0.661). Older age was a risk factor for arterial ED (OR=0.960, 95%CI: 0.938-0.982). Additionally, older age (OR=0.976, 95%CI: 0.958-0.993) and glucose levels of 5.6-6.9 mmol/L (OR=0.591, 95%CI: 0.399-0.876) were also risk factors for mixed arterio-venous ED. Conclusion: Hyperglycemia and aging may impair penile cavernous body vascular function, while higher levels of estrogen may have a protective effect on it.