万艾可治疗ED时对BPH引起LUTS改善的研究

目的 :探索、研究万艾可在治疗阴茎勃起功能障碍 (ED)时对由良性前列腺增生 (BPH)引起的下尿路症状(LUTS)的影响。　方法 :32例ED同时伴有BPH的研究对象 ,采用IIEF 5问卷表和IPSS评分表 ,在服用万艾可前和服药后 6个月分别各填写一次 ,应用单因素方差分析对所得到的前后评分进行统计学分析。结果 :在服药前32例ED中 ,轻、中、重分别为 14、13、5例 ,BPH中轻、中、重分别为 3、15、14例 ;服药后IIEF 5评分平均上升4 2 .36 % ,IPSS评分平均下降 2 0 .14 % ,两者在统计学上都有显著性差异 ,P <0 .0 1。　结论 :在治疗中老年性ED合并BPH中 ,应用万艾可既能治疗ED ,取得完美的性生活 ,又能达到改善由BPH引起的LUTS。万艾可是一治疗ED有效的药物 ,但对于前列腺基质平滑肌亦有辅助性松弛作用 ,因此也有助于BPH时LUTS的缓解。     

Effect of viagra on retinal vein diameter in AMD patients

The aim of the present study was to investigate the effect of sildenafil citrate (viagra) on retinal venous diameter in patients with age-related macular degeneration (AMD). We investigated 14 male patients in a double-masked, randomized, placebo-controlled, crossover study. In each subject, one eye with typical non-exudative AMD fundus features was studied. Each of the subjects received 100 mg dose of sildenafil or matching placebo on two separate study visits. Monochromatic fundus photographs were obtained in the study eye before dosing and then 30, 90, 180 and 300 min later. Measurements of the diameter of the major retinal veins from digitized negatives were carried out using "Vessel map" static vessel analysis program (IMEDOS GmbH, Weimar, Germany). Statistical analysis of the data comparing the effect of sildenafil and placebo on venous diameters was performed using analysis of variance (ANOVA) for repeated measures. An analysis of variance (ANOVA) comparing the effects of sildenafil citrate and placebo on retinal vein diameters showed a significant interaction between time and treatment (P = 0.03). In comparison to placebo, sildenafil citrate produced a statistically significant vasodilatation of major retinal veins of 4.7% at 90 min (P = 0.004), 5.5% at 180 min (P < 0.0001) and 5.8% at 300 min (P < 0.0001). At 30 min there was a 2.2% difference, which was not statistically significant (P=0.14). Our results suggest that in patients with age-related macular degeneration, sildenafil citrate (viagra) produces a statistically significant vasodilatation of major retinal veins that is similar to what has been reported in normal subjects. Whether this vasodilatation is associated with changes in retinal blood flow needs to be further investigated.     

口服万艾可改善子宫内膜容受性的初探

目的初步探讨万艾可改善子宫内膜容受性的作用。方法选择50例促排卵周期中子宫内膜生长不良的不孕患者,在下一个促排卵周期中周期第7～8天开始给予万艾可口服治疗,50mg/d,至子宫内膜厚度达到8.0mm或证实已排卵。结果排卵日子宫内膜厚度服药前为5.2～7.8(6.90±0.61)mm,服药后为3.7～14.0(7.78±1.81)mm,服药后子宫内膜厚度明显增加(95%可信区间为0.33～1.42mm,P=0.002)。服药后子宫内膜分型没有明显变化(P=0.907)。临床妊娠率显著提高(P=0.012)。结论万艾可能促进子宫内膜生长、改善子宫内膜容受性,有助于胚胎着床。     

Viagra for temporary erectile dysfunction during treatments with assisted reproductive technologies.

During treatments with assisted reproductive technologies (ART), some men may have difficulties in producing spermatozoa on demand at the time of insemination, either for intrauterine insemination (IUI) or for in-vitro fertilization (IVF). This situation imposes tremendous stress on the couple and may cause cancellation of the treatment. Here we describe, for the first time, the use of sildenafil citrate (ViagraTM) for temporary erectile dysfunction in couples undergoing ART. The first case was a man who could not produce spermatozoa for the first IVF treatment after an exhausting trial for 12 h, despite the fact that he never had problems in providing sperm samples during previous IUI cycles. Using Viagra enabled him to provide spermatozoa, but the delay in oocyte insemination resulted in no embryonic development. This prompted us to be more alert to this option and to suggest the use of Viagra to men who had a history of erectile dysfunction during previous ART cycles. In these cases, the use of Viagra was planned in advance and it successfully solved any unpredictable erectile dysfunction on the day of insemination. Such cases emphasize the need to think in advance of this potential use of Viagra during ART.