规律与按需使用西地那非治疗原发性高血压伴勃起功能障碍的疗效差异  

Difference of regular and on-demand sildenafil in the treatment of essential hypertension with erectile dysfunction

作　　者：杨鹏[1] 周辉良[1] 谢泓[2] 丁一郎 陈强[1] 黄海林 唐松喜 YANG Peng;ZHOU Hui-liang;XIE Hong;DING Yi-lang;CHEN Qiang;HUANG Hai-lin;TANG Song-xi(Department of Andrology,The First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350005,China;Department of Cardiology,The First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350005,China)

机构地区：[1]福建医科大学附属第一医院男科,福建福州350005 [2]福建医科大学附属第一医院心血管内科,福建福州350005

出　　处：《中华高血压杂志》2021年第11期1092-1096,共5页Chinese Journal of Hypertension

摘　　要：目的比较规律与按需使用西地那非治疗原发性高血压伴勃起功能障碍(ED)患者的差异。方法回顾性分析2018年5月至2019年6月就诊于福建医科大学附属第一医院的原发性高血压伴ED患者165例,分为规律用药组(n=83)及给按需用药组(n=82),治疗周期为12周,每4周随访一次,记录血压、心率、国际勃起功能指数5(IIEF-5)问卷及不良反应。结果最终患者149例完成随访,其中规律用药组79例,按需用药组70例。规律用药组有效率优于按需用药组(84.81%比71.43%,χ^(2)=3.94,P<0.05),不良反应发生率差异无统计学意义(7.22%比13.41%,χ^(2)=1.71,P=0.19),但其因药物因素退出率少于按需用药组(2.41%比10.98%,χ^(2)=4.86,P<0.05)。规律用药组和按需用药组治疗前后收缩压及舒张压差异有统计学意义(均P<0.05),心率、肝肾功能无明显波动。结论对于原发性高血压伴ED患者,采用规律个体化剂量西地那非治疗同时服用一种或多种降压药的ED患者的疗效比按需用药更好,安全性良好。Objective To compare the difference of regularly individualized and on-demand usage of sildenafil in patients with essential hypertension and erectile dysfunction(ED).Methods A retrospective analysis was conducted on 165 male patients with essential hypertension and ED from May 2018 to June 2019.They were divided into regular medication group(n=83)and on-demand medication group(n=82).The treatment period was 12 weeks.The patients were followed up every 4 weeks.Blood pressure,heart rate,international index of erectile function-5(IIEF-5)questionnaire and adverse reactions were recorded.Results One hundred and forty-nine patients were followed up,including 79 cases in the regular medication group and 70 cases in the on-demand medication group.The effective rate of the regular medication group was better than that of the on-demand medication group(84.81%vs 71.43%,χ^(2)=3.94,P<0.05),while the incidence of adverse reactions was not significantly different(7.22%vs 13.41%,χ^(2)=1.71,P=0.19).The rate of drug-related withdrawal was lower in the regular medication group(2.41%vs 10.98%,χ^(2)=4.86,P<0.05).There were significant improvements of systolic and diastolic blood pressure in both groups after the treatment.There was no significant fluctuation in heart rate,liver and kidney functions.Conclusion It is better and safer for ED patients to take individualized dosage of sildenafil regularly while taking one or more antihypertensive drugs than to take sildenafil on demand.

关 键 词：高血压 勃起功能障碍 西地那非 规律用药 按需用药 

分 类 号：R544.11[医药卫生—心血管疾病] R698.1[医药卫生—内科学]