西地那非治疗2型糖尿病患者勃起功能障碍疗效分析

目的 评价西地那非治疗2型糖尿病(DM)患者勃起功能障碍(ED)的临床疗效.方法 门诊筛查ED患者,符合入选标准及排除标准的ED并伴有2型DM患者42例作为实验组,另于门诊选择同期无DM的单纯ED患者40例作为对照组.按需给予西地那非治疗,3个月后随访,完善疗效评价量表.结果 实验组患者用药后IIEF-5评分,显著高于用药前两者比较差异有统计学意义(P<0.01).全球疗效问题阳性答复百分率为76.2%.与对照组患者相比差异无统计学意义(P>0.05).实验组患者按糖化血红蛋白水平(HbAlc)及DM病程(D)分为4组,其中HbAlC>7,D>5年组患者用药后IIEF-5评分为(16.00±0.82),用药前为(13.14±3.53),用药前后比较,差异具统计学意义(P<0.05).GEQ阳性答复率为42.9%,与对照组相比,差异具统计学意义(P<0.05).结论 西地那非治疗2型DM患者伴ED疗效确切.但伴有DM并发症的ED患者,效果欠佳.     

枸橼酸西地那非有效治疗2型糖尿病患者勃起功能障碍

男性糖尿病患者中90%为2型糖尿病(非胰岛素依赖型),勃起功能障碍(ED)是这类患者的常见并发症。Boulton等的研究评价了西地那非对2型糖尿病患者ED的疗效,并将结果与糖化血红蛋白浓度和慢性糖尿病并发症等因素进行了关联比较。在这项双盲、对照试验中,患者(平均年龄59岁)随机接受     

枸橼酸西地那非治疗2型糖尿病相关勃起功能障碍的疗效

糖尿病影响患者全身血管状态,是勃起功能障碍(ED)的危险因素。枸橼酸西地那非是治疗ED的有效口服药,而该药对2型糖尿病相关ED的疗效如何呢?El Sakka AI等人对466名ED患者(包括382名糖尿病和84名非糖尿病患者,平均年龄为(53±8.4)岁和(49.7±10.6)岁进行了研究[EurUrol,2004,46(     

西地那非治疗2型糖尿病患者勃起功能障碍有效且安全

勃起功能障碍（ED）是糖尿病常见的并发症，它使患者生活质量下降，丧失自尊，甚至影响性伴侣关系。西地那非是广泛应用于治疗ED的选择性PDE5抑制剂，其对2型糖尿病患者ED的疗效和安全性如何呢？     

2型糖尿病患者勃起功能障碍危险因素分析

阴茎勃起功能障碍（erectile dysfunction，ED）是糖尿病的常见并发症。糖尿病患者的ED较其他人群起病早，患病率高，与其他糖尿病并发症相比，未引起广大内分泌科医生足够的重视，患者亦很少得到充分的治疗，尤其是对糖尿病性ED发病的危险因素尚不清楚。本文旨在分析糖尿病ED的发生率及其影响因素，以利于及早干预治疗，从而预防糖尿病性ED的发生。     

2型糖尿病勃起功能障碍患者的性激素改变

本文报道2型糖尿病合并勃起功能障碍（ED）患者的血性激素及促性腺激素改变，对糖尿病（DM）患者的生殖内分泌领域进行初步探讨。     

西地那非治疗勃起功能障碍的临床疗效

目的 :观察西地那非对不同年龄和病因勃起功能障碍 (ED)病人的疗效。　方法 :88例ED病人口服不同剂量的西地那非 4～ 2 2周 ,以国际勃起功能指数 5 (IIEF 5 )评分为评估标准判断疗效 ,设对照组作比较。　结果 :西地那非治疗ED病人的总疗效率为 80 .7% ,IIEF 5值上升幅度与西地那非疗效呈正相关。不同年龄ED病人的疗效无明显差异。神经性ED病人的显效率和IIEF 5值与心因性病人差异显著。　结论 :西地那非治疗ED是安全有效的 ,IIEF 5可作为评判ED疗效的可靠指标。     

西地那非治疗勃起功能障碍的现状

简要介绍了西地那非的药理作用机制 ,着重阐述了该药对勃起功能障碍 (ED)的治疗效果及安全性 ,特别对高血压及服用抗高血压药物病人、心脏病病人、糖尿病病人、脊髓损伤病人、前列腺根治性手术后病人、长期透析病人等特殊人群的应用情况进行总结。西地那非对ED的治疗总体上有效、安全。     

勃起功能障碍的药物治疗

近年来,特别是5型磷酸二酯酶抑制剂———西地那非上市以来,众多学者对勃起功能的生物化学和生理学进行了深入研究,在勃起功能障碍(ED)药物治疗的基础和临床方面取得了许多新的进展。本文综述了多种作用于中枢和外周ED治疗药物的分子及细胞作用机制,为最近ED药物研究和进展中最具争议的领域提供一些详细资料。     

2型糖尿病伴勃起功能障碍的相关发病因素探讨

目的:探讨中青年2型糖尿病(T2DM)患者伴发勃起功能障碍(ED)与血管、神经和雄激素等因素的关系,为ED早期防治提供临床依据。方法:53例50岁以下男性T2DM患者按国际勃起功能指数-5(IIEF-5)评分分为ED组(IIEF评分≤21,n=28)和非ED组(NED组)(IIEF评分≥22,n=28),测定两组血脂、血糖、血清总睾酮(TT)、性激素结合蛋白(SHBG)、硫酸脱氢表雄酮(DHEA-S)、计算法游离睾酮(cFT)等指标,检查两组视网膜病变(DR)、大血管病变和周围神经病变(DPN)等并发症,比较两组各指标及并发症的差异。结果:两组年龄、糖尿病病程、体重指数、血压、血脂、血糖水平具有可比性(P>0.05),ED组DR发生率(39.3%)高于NED组(4.0%)(P<0.05),两组TT、DHEA-S、cFT水平及大血管病变和DPN发生率差异均无统计学意义(P>0.05)。结论:T2DM患者伴ED发生与DR关系密切,对合并DR的T2DM患者尤应早期关注其勃起功能。     

RigiScan诊断标准在高原地区ED诊疗中的临床应用

目的:探讨运用RigiScan监测数据诊断ED的标准在高原地区的适用性及评估疗效的临床应用。方法:收集西宁市第一人民医院男科门诊及住院病例586例,年龄18～48岁,平均年龄24.6岁,国际勃起功能指数评分(IIEF-5)及主观描述均得到准确诊断,然后使用RigiScan分别在AVSS模式及NPTR模式下进行监测,筛选AVSS及NPTR数据不正常者作为研究对象进行分层诊断,予以PDE5i药物个体化治疗1～6个月后停药一周和心理干预后行AVSS模式复查,并对其监测数据与IIEF-5评分及主观描述治疗前后对比分析。结果:586例均行AVSS监测筛查,其中3例正常,583例AVSS异常(无有效勃起即阴茎头端勃起硬度<60%、维持时间<10 min),再行NPTR 57例正常(有效勃起即阴茎头端勃起硬度≥60%、维持时间≥10 min);116例放弃NPTR监测;410例AVSS及NPTR均不正常,根据NPTR监测数据(头端勃起硬度百分数)分为轻度ED(40～59%)、中度ED(20～39%)、重度ED(0～19%)分别予以PDE5i药物按需不同疗程治疗及心理干预后应用AVSS模式复查,将治疗前NPTR监测数据与治疗后AVSS复查监测数据对比分别为:无有效勃起(410例),其中轻度ED 207例(50.5%)、中度ED 176例(42.9%)、重度ED 27例(6.6%);有效勃起255例(62.2%),其中轻度ED 172例(42.0%)、中度ED 83例(20.2%);好转124例(30.2%),其中轻度ED 35例(8.5%)、中度ED 77例(18.8%)、重度ED 12例(2.9%),具有显著性统计学差异(P<0.05);IIEF-5评分治疗前后分别为(11.62±3.64)分、(18.62±2.96)分,具有显著性统计学差异(P<0.05);治疗后主观描述勃起功能及控制能力较前明显改善。结论:RigiScan可以客观判断ED是否存在并区分心理性和器质性病因以及严重程度。AVSS检查应用于初步筛查ED病因及评估药物和心理干预的治疗效果。本研究表明在高原地区ED患者运用RigiScan采用AVSS及NPTR模式的监测数据诊断标准与国际标准是一致符合的,适用于高原地区ED患者,并可以为ED临床诊疗提供重要依据,值得在高原地区推广应用。     

己酮可可碱治疗勃起功能障碍的临床研究

目的　为探讨己酮可可碱治疗勃起功能障碍 (ED)的有效性。方法　以勃起功能国际问卷 (IIEF 5 )的量表作为指标 ,对 30例ED患者进行了临床观察。结果　服用己酮可可碱后阴茎勃起功能明显改善 ,有效率为6 3.33%。结论　己酮可可碱可以用于ED的临床治疗     

Efficacy of sildenafil citrate in treatment of erectile dysfunction: effect of type 2 diabetes

PURPOSE: To assess efficacy of sildenafil citrate in treatment of erectile dysfunction: effect of type 2 diabetes. MATERIALS AND METHODS: A total of 466 male patients with erectile dysfunction (ED) were enrolled in this study. Of them 382 were diabetic and 84 were non-diabetic. Patients were screened for ED using the erectile function domain of the International Index for Erectile Function (IIEF). Patients underwent routine laboratory investigations, in addition to total testosterone and prolactin assessment. To assess the effect of diabetes on efficacy of sildenafil, we compared the pre and post sildenafil responses to erectile function domain, Q3, Q4. Overall satisfaction and global efficacy question (GEQ) were also assessed. RESULTS: Mean age +/- S.D. was 53 +/- 8.4 and 49.7 +/- 10.6 years for patients with and without diabetes respectively. There were significant associations between increased severity of ED and longer duration, poor metabolic control and presence of more than one diabetes-related complication (p < 0.05 for each). Differences were significant between pre and post sildenafil administration regarding erectile function domain, Q3, Q4 (p < 0.05 for each). In the non-diabetic patients the GEQ and the overall satisfaction were significantly higher than in diabetics (p < 0.05 for each). Global efficacy question was significantly low in patients with fair and poor metabolic control, longer duration of diabetes, and patients with diabetic complications (p < 0.05 for each). CONCLUSIONS: Sildenafil is an effective treatment for diabetic patients with ED. Although the efficacy of sildenafil was negatively affected by factors as poor control and longer duration of diabetes and presence of more than one diabetes-related complication, however, the global efficacy and the overall patients' satisfaction were high.     

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.     

Clinical and psychological predictors of incidence of self-reported erectile dysfunction in patients with type 2 diabetes

PURPOSE: We evaluated the predictors of the incidence of erectile dysfunction in patients with type 2 diabetes mellitus and identified subgroups of patients in whom the interaction between clinical and psychological characteristics determined an increase in the risk of erectile dysfunction. MATERIALS AND METHODS: The study was based on 670 individuals. The presence of erectile dysfunction and the severity of depressive symptoms were investigated with a questionnaire filled in every 6 months for 3 years. Poisson regression was used to calculate incidence rates. To evaluate interactions among the different variables and identify distinct and homogeneous subgroups in terms of incidence of erectile dysfunction, RECursive Partitioning and AMalgamation method was used. RESULTS: Overall erectile dysfunction developed in 192 men with type 2 diabetes, with an incidence rate of 166.3 per 1,000 person-years. Age, insulin treatment, hemoglobin A1c greater than 8.0%, total cholesterol greater than 3.88 mmol/l and severity of depressive symptoms represented independent predictors of erectile dysfunction. RECursive Partitioning and AMalgamation analysis identified 5 classes with a marked variation in the risk of erectile dysfunction. Patients with low levels of depressive symptoms and hemoglobin A1c 8.0% or less showed the lowest risk of erectile dysfunction. Compared with this subgroup patients with higher levels of depressive symptoms and treated with insulin had a 3-fold risk of erectile dysfunction. Age, smoking, high cholesterol levels and neuropathy were globally predictive variables associated with an increased risk of erectile dysfunction. CONCLUSIONS: The incidence of erectile dysfunction is predicted by modifiable risk factors. Even in diabetes, psychological problems can contribute to the pathogenesis of erectile dysfunction, in addition to organic causes.     

Pharmacological treatment of erectile dysfunction

There is growing evidence that the field of pharmacotherapy, particularly oral drugs, will be dominant in the future management of sexual dysfunction. Basic research has led to the understanding of the intracellular mechanisms that control penile smooth muscle contractility and therefore erection, opening a vast area for pharmacological intervention. Moreover, the importance of central neurohormonal mechanisms has made these pathways the target for new centrally acting drugs. Given these trends most patients suffering from erectile dysfunction will respond to pharmacological agents in the not so distant future.     

需手术治疗的勃起功能障碍

由于西地那非(万艾可,英文名Viagra)为代表的磷酸二酯酶-5抑制剂的广泛应用,各种原因引起的勃起功能障碍(ED)的治疗有效率明显提高,使手术治疗ED的比例下降。但对于一线、二线治疗方案无效的患者,以及某些阴茎发育或形态上的畸形影响性生活者,手术治疗仍是有效的方法[1-2],主要包括阴茎假体的植入、阴茎血流重建、各种阴茎畸形矫正和阴茎重建等方法,重塑阴茎的形态和功能,以满足外观、功能和性活动的需要。一、阴茎假体植入术自从1952年,Goodwin及Scott将丙烯酸支撑物植入阴茎以改变阴茎的硬度以来,先后研制并使用了聚乙烯和硅做成的柱形…