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病灶内注射干扰素α-2B联合口服维生素E治疗佩罗尼氏病

Combined intralesional interferon alpha 2B and oral vitamin E in the treatment of Peyronie's disease.

作者信息

Novak T E, Bryan W, Templeton L, Sikka S, Hellstrom W J

机构信息

Urological Residency Program, Walter Reed Medical Center, Washington, DC, USA.

出版信息

J La State Med Soc. 2001 Jul;153(7):358-63.

Abstract

It has been recently reported that intralesional therapy with alpha interferon 2B resulted in significant improvement of both objective and subjective complaints (penile curvature, pain, plaque size, sexual function) associated with Peyronie's disease. Vitamin E, with its antioxidant properties, may play a role in reducing the inflammatory response. This study was designed to determine the safety and effectiveness of a high dose of alpha INF-2B injected weekly into the Peyronie's plaque combined with oral Vitamin E therapy. Twenty-nine patients with Peyronie's disease were evaluated with penile duplex Doppler for degree of penile curvature, deformity, and plaque size both prior to and after treatment. Each patient then received 4.0 x 10(6) units of alpha INF-2B in 10 cc of normal saline after appropriate local anesthesia. Injections were given once per week directly into the Peyronie's plaque for a period of 10 weeks. Patients also received 400 units of Vitamin E by mouth twice a day. Subjective data was obtained via a questionnaire prior to and at the conclusion of the study. Preliminary results demonstrated improvement of penile curvature in 39% of patients, with one patient experiencing complete resolution. Significant decreases in plaque sizes were noted in 11 of these patients, with softening of the plaques noted in all patients completing the study. Seven patients dropped out of the study prior to completing the 10 weeks: three with severe disease proceeded to surgery, two were lost to follow-up, one had exascerbation of his arthritis symptoms, and one quit secondary to flu-like symptoms. Subjective data from questionnaires revealed improvement in sexual function in those men with decreased curvature and plaque size. Weekly intralesional injections with 4.0 x 10(6) units improved plaque consistency and decreased curvature and plaque size (P < 0.5). Overall subjective sexual performance was reportedly improved. Increased dosage of alpha INF-2B resulted in increased severity of flu-like symptoms when compared to the lower (1 x 10(6) units) biweekly dosage. No significant difference was noted with the addition of oral Vitamin E therapy.

摘要

最近有报道称,病灶内注射α干扰素2B可显著改善佩罗尼氏病相关的客观和主观症状(阴茎弯曲、疼痛、斑块大小、性功能)。维生素E具有抗氧化特性,可能在减轻炎症反应中发挥作用。本研究旨在确定每周向佩罗尼氏斑块内注射高剂量α干扰素-2B并联合口服维生素E治疗的安全性和有效性。对29例佩罗尼氏病患者在治疗前后进行阴茎双功多普勒检查,以评估阴茎弯曲程度、畸形情况和斑块大小。然后在适当的局部麻醉下,每位患者接受10毫升生理盐水中含4.0×10⁶单位的α干扰素-2B。每周直接向佩罗尼氏斑块内注射一次,持续10周。患者还每天口服两次400单位的维生素E。在研究开始前和结束时通过问卷获取主观数据。初步结果显示,39%的患者阴茎弯曲情况有所改善,其中1例患者完全恢复。这些患者中有11例斑块大小显著减小,所有完成研究的患者斑块均出现软化。7例患者在完成10周治疗前退出研究:3例病情严重者接受了手术,2例失访,1例关节炎症状加重,1例因类似流感症状而退出。问卷中的主观数据显示,阴茎弯曲和斑块大小减小的男性性功能有所改善。每周病灶内注射4.0×10⁶单位可改善斑块质地,减小弯曲度和斑块大小(P<0.5)。据报道,总体主观性功能有所改善。与较低的(1×10⁶单位)每两周一次的剂量相比,增加α干扰素-2B的剂量会导致类似流感症状的严重程度增加。添加口服维生素E治疗未发现显著差异。

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