Jarow J P, Burnett A L, Geringer A M
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Urol. 1999 Sep;162(3 Pt 1):722-5. doi: 10.1097/00005392-199909010-00024.
We assess the clinical efficacy of sildenafil citrate and predictors of satisfactory outcome.
All patients treated with sildenafil citrate within the first 6 weeks of its release were evaluated with a self-administered questionnaire before and at completion of therapy to assess etiology of erectile dysfunction, level of sexual function, libido, response to previous therapies, response to therapy with sildenafil citrate and quality of life. Sexual function was measured before and during therapy using an abbreviated version of the International Index of Erectile Function, with a successful outcome defined as a level of satisfaction of 4 or 5 on a 5-point scale.
Followup was obtained in 267 of the 308 patients who entered the study. Mean age plus or minus standard deviation was 61+/-9.6 years and duration of erectile dysfunction was 4.1+/-3 years. Overall satisfaction with sildenafil citrate for the entire patient population was 65% and response to prior therapies did not affect satisfaction. There was a significant positive correlation between baseline sexual function and response to sildenafil citrate but even patients with severe erectile dysfunction had a 41% satisfaction rate. Etiology of erectile dysfunction had a significant impact on satisfaction rate, with neurogenic causes of erectile dysfunction (diabetes, prostate surgery and so forth) having significantly lower rates than psychogenic or vasculogenic erectile dysfunction.
Sildenafil citrate is a highly effective oral agent for the treatment of erectile dysfunction in clinical practice. The best predictors for response to sildenafil citrate therapy are baseline sexual function and etiology of erectile dysfunction. However, we could not identify any patient characteristic that would predict absolute failure for sildenafil citrate therapy. Therefore, all patients with erectile dysfunction who do not have specific contraindications should be considered for sildenafil citrate therapy.
我们评估枸橼酸西地那非的临床疗效及满意结果的预测因素。
对在枸橼酸西地那非上市的前6周内接受治疗的所有患者，在治疗前及治疗结束时采用自填问卷进行评估，以评估勃起功能障碍的病因、性功能水平、性欲、对既往治疗的反应、对枸橼酸西地那非治疗的反应及生活质量。在治疗前及治疗期间使用国际勃起功能指数简化版测量性功能，成功结果定义为在5分制量表上满意度达到4或5分。
308例进入研究的患者中有267例获得随访。平均年龄±标准差为61±9.6岁，勃起功能障碍持续时间为4.1±3年。整个患者群体对枸橼酸西地那非的总体满意度为65%，对既往治疗的反应不影响满意度。基线性功能与对枸橼酸西地那非的反应之间存在显著正相关，但即使是重度勃起功能障碍患者的满意率也达41%。勃起功能障碍的病因对满意率有显著影响，勃起功能障碍的神经源性病因（糖尿病、前列腺手术等）的满意率显著低于心因性或血管源性勃起功能障碍。
枸橼酸西地那非在临床实践中是治疗勃起功能障碍的高效口服药物。对枸橼酸西地那非治疗反应的最佳预测因素是基线性功能和勃起功能障碍的病因。然而，我们无法确定任何可预测枸橼酸西地那非治疗绝对失败的患者特征。因此，所有无特定禁忌证的勃起功能障碍患者均应考虑接受枸橼酸西地那非治疗。
