他达拉非:ED患者及其配偶的选择偏爱?

勃起功能障碍(erectile dysfunction,ED)是男性常见疾病,直接影响患者及其配偶的生活质量。PDE5抑制剂是治疗ED的首选药物。尽管临床主要有3种PDE5抑制剂(西地那非、伐地那非和他达拉非)可供选择,但是患者及其配偶在选择PDE5抑制剂上是否有偏好,以及影响其选择的因素又有哪些本文简要地综述了最近的研究进展。     

持续小剂量口服他达拉非治疗ED的疗效观察

目的 评估持续口服小剂量他达拉非治疗ED的疗效.方法 124例ED患者随机分为两组:希爱力(他达拉非商品名)组和复方玄驹组,分别接受为期3个月的治疗,治疗后各组随访6个月.在治疗前后及随访6个月后记录各组患者IIEF-5评分及患者性生活日记中插入和保持勃起的成功率并比较研究.结果 治疗前2组患者IIEF-5评分分别为(10.26±4.35)分、(10.38±3.42)分,差异无统计学意义(P＞0.05).治疗后IIEF-5评分分别为(20.464±3.05)分、(15.58±4.32)分;随访6个月后IIEF-5评分分别为(18.46 4±2.47)分、(11.58±3.15)分,差异均有统计学意义(P＜0.01).治疗后及随访后两组间差异有统计学意义(P＜0.05).药物治疗后,患者日记中插入和保持勃起的成功率人幅度增高,希爱力组优于复方玄驹组.结论 在治疗ED疗效方面,持续口服小剂量他达拉非优于中成药复方玄驹,可作为治疗ED的一线用药.     

他达拉非治疗勃起功能障碍的安全性研究

环磷酸鸟苷(cGMP)信号通路介导的一氧化氮平滑肌舒张效应是正常勃起功能的必要条件。这个信号通路的下调能引起勃起功能障碍(erectile dysfunction,ED)的许多病理生理状况,并导致一些慢性疾病的发生,比如高血压和2型糖尿病。因此,选择性抑制cGMP降解酶能够促进性刺激的勃起反应。最近,一种新型的5-磷酸二酯酶(PDE-5)抑制剂他达拉非问世,该药有很长的半衰期。本文对其治疗ED的安全性研究进行了综述。     

首诊治疗成功后不同剂量他达拉非治疗勃起功能障碍病例报告

<正>勃起功能障碍(erectile dysfunction,ED)发病率居高不下,美国40～70岁男性ED的发病率为52.0%,而整个人群的完全性ED的患病率为9.6%[1],我国城市男性的ED总发病率为26.1%[2]。用于改善局部或周围神经系统的5型磷酸二酯酶(PDE5)抑制剂是迄今治疗ED最有效的     

他达拉非治疗ED的进展

他达拉非是治疗ED的有效药物,大量的研究已经证实了其在ED患者中的临床疗效。相对于西地那非和伐地那非,他达拉非最为显著的特点是它的长效性,接受治疗的ED患者可以在长达36 h的时间窗内自然地达到有效的勃起。他达拉非对患有内科合并症的ED患者具有良好的疗效,它还能有效地改善患者的心理以及晨勃现象,使患者恢复生活的自信。他达拉非的长效性使患者性生活符合“自然、愉快、正常的性生活”这一治疗要求,从而成为越来越多患者的首选药物。     

他达拉非在阴茎勃起功能障碍中的疗效评价

他达拉非是一种口服治疗勃起功能障碍的PDE-5抑制剂药物,其作用时间可以维持到服用药物后36h,具有良好的有效性和安全性,并且可以改善由其它疾病导致的勃起功能障碍,本文对他达拉非治疗阴茎勃起功能障碍的疗效进行综述。     

他达拉非治疗ED疗效和安全性新进展

他达拉非——长效5型磷酸二酯酶(PDE5)抑制剂是治疗勃起功能障碍(ED)的首选药物之一。许多临床研究证实其在普通ED患者、老年患者以及伴有糖尿病、脊髓损伤或前列腺癌术后患者中有较好的疗效和良好的安全性及耐受性,而且其独特的长达36 h的时间窗不仅增强了患者的自信心,更改善了患者及其伴侣的生活质量。     

他达拉非治疗ED的概述

勃起功能障碍(ED)是男科常见病、多发病,PDE5抑制剂能竞争性抑制PDE5而抑制cGMP的水解,提高阴茎海绵体平滑肌细胞内cGMP浓度,达到治疗ED的效果。他达拉非可使阴茎海绵体内cGMP水平提高,从而导致勃起。他达拉非可有效改善各种病因和各种程度ED患者的勃起功能;其具有以下特点:有效时间长,安全性高,易于被患者及性伴侣接受,增强性自信、性自尊,性体验更加自然。使患者从生理、心理上最大程度的得到治疗,有效提高性生活质量。因此他达拉非在ED患者的治疗中值得推广。     

ED诊疗过程中心理因素的作用

勃起功能障碍(ED)是受生理和心理因素共同作用的性功能障碍疾病.生理上ED的发生与血管内皮的功能退化和性兴奋反射调节机制的紊乱紧密相关,而心理上性欲低下,焦虑和抑郁心理会直接导致ED的发生.心理因素在ED诊断和治疗中的作用近年来日益受到重视,各项对ED患者性心理进行评估的问卷为我们提供了评估心理因素对患者影响的工具.基...     

他达拉非治疗勃起功能障碍的安全性研究进展

勃起功能障碍(erectile dysfunction,ED)是中老年人的常见疾病。他达拉非自2002年10月开始用于治疗ED,其疗效确切,安全性高,因此越来越多的患者选择他达拉非来治疗ED。目前对他达拉非的作用机制、药代动力学、疗效、安全性等方面已经有了较多的基础及临床研究资料。本文就他达拉非治疗ED的安全性做一综述,以求该药物在临床上得到更安全的使用,为临床医生选择使用该类药物提供参考。     

他达拉非用于前列腺术后阴茎康复的研究进展

前列腺癌根治性切除术(RP)是治疗绝大多数临床局限性前列腺癌的标准术式,保留神经的NSRRP术式的广泛采用使得RP的疗效得到了显著的提升,但是对RP术后勃起功能的保护仍是泌尿外科的难题。RP术后及早开始阴茎康复可显著改善RP术后勃起功能障碍(ED)对患者的术后生活质量。作为唯一的长效选择性磷酸二酯酶-5抑制剂(PDE5Is),他达拉非在RP术后阴茎康复中的显著疗效在临床试验和基础研究中均得到了证实。本文旨在回顾目前RP术后ED的相关进展,及他达拉非在RP术后阴茎康复中的有效性和安全性证据。     

Tadalafil in the treatment of erectile dysfunction

Oral phosphodiesterase-5 inhibitors have emerged as the preferred first-line treatment for erectile dysfunction worldwide because of patient convenience, efficacy, and safety. Clinical trials have shown that tadalafil significantly enhances erectile function across a wide range of etiologies and provides a prolonged period of effectiveness independent of food or alcohol. In this review, the pharmacokinetic and pharmacodynamic characteristics, efficacy, and safety of tadalafil are discussed.     

心血管疾病患者并发勃起功能障碍的危险因素分析

目的:调查男性心血管疾病住院患者的勃起功能,探讨心血管疾病中勃起功能障碍(ED)的发生率及其危险因素与勃起功能的关系。方法:自行设计问卷,对西安交通大学第一、第二附属医院心血管内科住院的男性患者进行问卷调查,测量身高、体重、腰围、臀围、血压等数据;收集个人基本信息、既往史(包括吸烟史、饮酒史,高血压、冠心病、心律失常、心绞痛、心肌梗死病史、糖尿病病史等),记录代谢参数检查结果。同时以IIEF-5进行勃起功能评分。采用单变量、多变量Logistic回归分析及比值比(OR)确定ED的危险因素。结果:本研究共纳入有效问卷225份,经统计分析发现在整个调查人群中ED的发病率为66.7%。其中轻度、轻中度、中度、重度ED的发病率分别为15.8%、27.0%、17.6%、6.3%。各组别(18~35岁、36~49岁、50~65岁、65岁)人群ED的发病率分别为13.6%、39.1%、89.2%、91.2%。单变量Logistic回归显示,心血管疾病并发ED的危险因素包括年龄(OR=3.122,95%CI:2.040~4.779)、吸烟(OR=1.768,95%CI:1.209~2.584)、BMI(OR=1.261,95%CI:1.114~1.427)、总胆固醇(OR=1.77,95%CI:1.339~2.34)、TC/HDL(OR=1.715,95%CI:1.349~2.181)、高血压(OR=1.717,95%CI:1.110~2.658)及冠心病(OR=2.235,95%CI:1.169~4.275)。而多变量Logistic回归分析显示,心血管疾病并发ED的危险因素分别为年龄(OR=4.99,95%CI:2.264~10.998)、经济情况(OR=2.804,95%CI:1.127~6.976)、吸烟(OR=2.109,95%CI:1.179~3.772)、BMI(OR=1.414,95%CI:1.136~1.76)和TC/HDL(OR=2.001,95%CI:1.016~3.943)。结论:在我国心血管疾病男性住院患者中ED的发病率很高,并随着年龄的增长而升高。年龄、吸烟、经济情况、BMI、TC/HDL是ED的危险因素,心血管病与ED存在着共同的危险因素,包括年龄、吸烟、BMI、TC/HDL,而经济情况在研究中被证实与ED关系密切,为以后的研究提供了新的思路。     

Intracavernous injections for erectile dysfunction in patients with cardiovascular diseases and failure or contraindications for sildenafil citrate

The aim of this study was to evaluate the effectiveness of a progressive program for the treatment of erectile dysfunction in patients with cardiovascular disease in whom sildenafil citrate (Viagra) was not an option. The study population included 106 patients selected from 267 with cardiovascular disease. The intracavernous injection program consisted of three protocols of increasingly complex combinations of vasoactive drugs, papaverine, phentolamine, prostaglandin E1 and atropine sulfate. Patients who failed the first protocol were switched to the second, and those who failed the second were switched to the third. A positive response was defined as an erection sufficient for vaginal penetration. A positive response was achieved on protocol I in 61 of the 106 patients (57.5%); protocol II in 32 of the remaining 45 patients (71.1%); and protocol III in seven of the remaining 13 patients (53.8%); the total success rate was 94.3%. These 100 patients were included in the 1-year follow-up, and 90 reported successful coitus at the end of that period: 79 patients (87.8%) with intracavernous injection and 11 (12.2%) without injection. The remaining 10 patients (10%) dropped out of the program, seven (7.0%) for health or marital reasons and three (3.0%) because of treatment failure. We conclude that a progressive program of intracavernous injections of vasoactive drugs may be a good alternative for the treatment of erectile dysfunction in patients with cardiovascular disease.     

Hypertension is associated with severe erectile dysfunction

PURPOSE: The prevalence and severity of erectile dysfunction in patients with hypertension need to be further evaluated. We evaluate medical and hypertension status, and erectile function in patients with hypertension. MATERIALS AND METHODS: The International Index of Erectile Function, which is a detailed questionnaire, including well established components to evaluate patient medical history, hypertension status and erectile dysfunction, was mailed to 476 male patients of the outpatient Hypertension Center of Columbia Presbyterian Medical Center. RESULTS: The questionnaire was completed by 104 (22.3%) patients, and mean age was 62.2 years (range 34 to 75). Of the patients 84.8% were sexually active and 68. 3% had various degrees of erectile dysfunction, which was mild in 7. 7%, moderate in 15.4% and severe in 45.2%. Compared to the general population of erectile dysfunction cases in the literature our study population with hypertension had a higher incidence of severe erectile dysfunction. Although correlations of antihypertensive medications with incidence of erectile dysfunction did not reach statistical significance, there was a clear trend with patients treated with diuretics and beta-blockers having the highest incidence and those treated with alpha-blockers having the lowest incidence of erectile dysfunction. CONCLUSIONS: In addition to the observation that erectile dysfunction is more prevalent in patients with hypertension than in an age matched general population, our study shows that it is more severe in those with hypertension than in the general population.     

Analysis of cardiovascular risks for erectile dysfunction in Chinese patients with type 2 diabetes mellitus lacking clinical symptoms of cardiovascular diseases

BackgroundErectile dysfunction (ED) is common but usually underdiagnosed in diabetics. The correlation between different vascular lesions and ED in diabetics without clinical cardiovascular symptoms is unknown. The aim was to explore the association between cardiovascular risks and ED in Chinese type 2 diabetic men lacking clinical performance.MethodsErectile function of patients with type 2 diabetes was assessed by the 5-item International Index of Erectile Function (IIEF-5) questionnaire. The data of clinical characteristics and vascular lesions at carotid and lower limb sites assessed by the Doppler ultrasound were collected to evaluate diabetes- metabolic indices. Univariate and multivariate analyses were conducted to find statistical correlation between cardiovascular risks and diabetic ED.ResultsA total of 71.21% reported suffering from ED. Lower limb plaques were more common (45.38%) than carotid district (35.62%) in diabetes. Men with ED had higher carotid intima-media thickness (IMT) (P<0.001) and the presence of lower limb plaques (P<0.001) compared with men without ED. After adjusting for age, diabetic duration, blood pressure (BP) and antidiabetic medication, carotid IMT greater than 0.75 mm (P<0.001) and the presence of lower limb plaques (P=0.051) remained associated with the presence of ED and its severity. Compared with isolated atherosclerosis at carotid or lower limb district, vascular lesions at any site and both sites were more correlative with ED presence (all P<0.001).ConclusionsThe prevalence of ED is high among Chinese diabetic men. A higher carotid IMT and the presence of lower limb plaques indicate a tight correlation between peripheral atherosclerosis and diabetic ED. ED may be the only clinical association of symptomatic cardiovascular diseases (CVDs) in diabetes. It is significant to screen ED to prevent the further development of severe symptomatic CVDs.