西地那非治疗男性肾移植受者勃起功能障碍的有效性和安全性  

Efficacy and safety of sildenafii for erectile dysfunction after kidney transplantation

作　　者：田晓辉[1] 薛武军[1] 田普训[1] 丁小明[1] 侯军[1] 冯新顺[1] 潘晓鸣[1] 燕航[1] 项和立[1] 李杨[1] 丁晨光[1] 

机构地区：[1]西安交通大学医学院第一附属医院肾脏病医院肾移植科,西安710061

出　　处：《中华器官移植杂志》2013年第10期600-603,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金项目（30972947,81270548）

摘　　要：目的评价肾移植术后受者应用西地那非治疗勃起功能障碍（ED）的有效性和安全性。方法选择192例肾移植术后半年以上，且移植肾功能良好的已婚男性受者进行勃起功能国际问卷（IIEF）调查评分，并以此判定是否患ED。收集受者的一般临床资料、病史和实验室检查资料。首先对ED患者进行心理治疗，未改善者再使用西地那非治疗。治疗4周后再次进行IIEF评分，并检测肝肾功能、血常规、血脂、电解质、血环孢素A或他克莫司的浓度谷值，观察和记录血压变化和药物不良反应。结果192例肾移植受者中，85例经心理治疗无效的患者使用了西地那非治疗，治疗4周后IIEF评分明显改善，临床总有效率为83．5％。患者血压、血肌酐、血环孢素A或他克莫司浓度谷值无显著性变化（P〉0．05），使用环孢素A者的西地那非用量为（72．4±27．7）mg／次，明显高于使用他克莫司者的西地那非用量（43．7±21．9）mg／次（P〈0．05）。使用西地那非后不良反应轻微。结论肾移植术后。肾功稳定患者应用西地那非治疗ED有效、安全。使用低剂量的西地那非未对环孢素A或他克莫司的代谢和移植肾功能产生明显影响。Objective To evaluate the efficacy and safety of sildenafil in these patients with erectile dysfunction （ED） as well as its effects on cylosporine/tacrolimus concentrations and graft function. Method One hundred and ninetytwo married males, who had received kidney transplantations at least half a year before and with stable kidney function, were selected randomly in the study. ED was assessed and diagnosed using the self-administered International Index of Erectile Function （IIEF）, and those with ED undergoing unsuccessful psychotherapy were treated with sildena.fil for 4 weeks. The efficacy of sildenafil was assessed by readministering the IIEF questionnaire after 4 weeks of therapy. Blood pressure, serum creatinine levels, and cyclosporine/tacrolimus trough concentrations were measured before and after sildenafil therapy. Results Eighty five recipients with ED received sildenafil for 4 weeks. The IIEF scores of each question were increased significantly and sildenafil treatment was effective in 71 patients （83.5%）. Blood pressure, serum creatinine levels, and cyelosporine/tacrolimus trough concentrations had no significant change before and after sildenafil treatment. The dosage of sildenafil in recipients with cyclosporine was higher than that of recipients with tacrolimus （72. 4 ± 27. 7 mg vs. 43.7 ± 21.9 rag, P〈0. 05）. Side effects were slight. Conclusion This study demonstrated that sildenafil treatment for kidney-transplant patients with ED was effective and safe. It is necessary to further study metabolic effects of sildenafil therapy on cyelosporine/tacrolimus.

关 键 词：肾移植 勃起功能障碍 西地那非 

分 类 号：R698[医药卫生—泌尿科学]