选择不同剂量他达拉非治疗ED的临床标准初步探索

目的:本文通过观察不同剂量他达拉非(希爱力)对于勃起功能障碍(ED)患者的治疗效果,探索他达拉非剂量与阴茎血流彩色多普勒参数之间的关系。方法:对136例ED患者在治疗前后进行IIEF-5评分同时用彩色多普勒超声联合阴茎血管活性药物前列腺素(PGE1)注射试验,检测阴茎双侧海绵体动脉的收缩期最大流速(PSV)。根据治疗前不同的PSV值,随机分为4组,采用了疗程为4周的隔日晚餐后口服不同剂量他达那非的用药方案。A组:PSV>15 cm/s,选择10 mg剂量;B组:PSV>15 cm/s,选择5 mg剂量;C组:PSV<15 cm/s,选择10 mg剂量;D组:PSV<15 cm/s,选择5 mg剂量。结果:治疗4周后,经统计学分析,4组IIEF-5评分以及阴茎双侧海绵体动脉的PSV与治疗前相比均有显著提高(P<0.01)。而且治疗4周后,A组与B组IIEF-5评分以及阴茎双侧海绵体动脉的PSV之间没有明显差异;C组却显著高于D组(P<0.01)。结论:隔日口服不同剂量的他达那非均能有效提高ED患者阴茎海绵体动脉的收缩期最大流速,改善患者的勃起质量。PSV>15 cm/s的ED患者可选择小剂量5 mg隔日;PSV<15 cm/s的ED患者尽量选择较大剂量10 mg隔日,以取得更好的疗效。

Standard doses of tadalafil for different ED patients

Objective:To observe the effects of different doses of tadalafil on ED,and to search for appropriate doses for the treatment of different ED patients.Methods:Based on the baseline peak systolic velocity(PSV) of cavernosal arteries,136 ED patients were divided into Groups A(PSV > 15 cm/s),B(PSV > 15 cm/s),C(PSV < 15 cm/s) and D(PSV < 15 cm/s) to receive oral tadalafil at 10 mg(Groups A and C) and 5 mg(Groups B and D) on alternate days for 4 weeks.All of them were scored on IIEF-5 and detected for PSVs of the bilateral cavernosal arteries by color Doppler ultrasonography and intracavernous injection of prostaglandin E1 before and after the medication.Results:After 4 weeks of tadalafil treatment,IIEF-5 scores and PSVs were remarkably improved in all the four groups as compared with the baseline(P < 0.01),significantly higher in Group C than in D(P < 0.01),but with no significant differences between A and B.Conclusion:Oral tadalafil can improve PSV and hence penile erection in ED patients either at a low or a high dose.To reduce side effects and drug cost,the patients with PSV > 15 cm/s can be medicated at 5 mg,while those with PSV < 15 cm/s at 10 mg or more on alternate days.Natl J Androl,2010,16(9):860-863