Doğru M Tolga, Başar M Murad, Simşek Ali, Yuvanç Ercan, Güneri Mahmut, Ebinç Haksun, Batislam Ertan
Department of Cardiology, University of Kirikkale School of Medicine, Kirikkale, Republic of Turkey.
Urology. 2008 Apr;71(4):703-7. doi: 10.1016/j.urology.2007.11.059.
To investigate the effect of statin treatment on serum sex steroid levels, heart rate variability, erectile function, and libido in patients with hyperlipidemia.
A total of 74 patients (mean age 44.7 +/- 7.1 years) with hyperlipidemia were enrolled into this study. After a cardiac examination, the serum lipid levels were measured, and the 24-hour Holter monitoring, heart rate variability, and autonomic test results were also evaluated. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire. Later, atorvastatin 40 mg/day was initiated in all patients and used for the subsequent 12 months. All diagnostic tests (cardiac, biochemical, and autonomic and the IIEF questionnaire) were performed again at 6 and 12 months of follow-up.
A statistically significant decrease was found in the serum lipid levels at 6 months (P <0.05). In contrast, the average IIEF scores (24.7 +/- 6.4 at baseline) had increased to 25.0 +/- 4.9 and 26.1 +/- 5.9 at 6 and 12 months of follow-up, respectively. Although the parasympathetic activities increased and sympathetic activities decreased with atorvastatin treatment, these changes were not statistically significant (P >0.05). In paired comparison, significant differences were found among the IIEF scores of the three periods (P = 0.013). The difference was more evident after 6 months of treatment (IIEF(1vs2) = 0.475; IIEF(1vs3) = 0.027; IIEF(2vs3) = 0.012).
Although improvement in the lipid profile occurred early during the statin treatment, restoration of erectile function appeared later, which could be attributed to the restoration of endothelial functions by lowered serum lipid levels.
探讨他汀类药物治疗对高脂血症患者血清性激素水平、心率变异性、勃起功能和性欲的影响。
本研究共纳入74例高脂血症患者（平均年龄44.7±7.1岁）。在进行心脏检查后，测量血清脂质水平，并评估24小时动态心电图监测、心率变异性和自主神经测试结果。使用国际勃起功能指数（IIEF）问卷评估勃起功能。随后，所有患者开始服用阿托伐他汀40mg/天，并持续使用12个月。在随访的6个月和12个月时再次进行所有诊断测试（心脏、生化、自主神经和IIEF问卷）。
6个月时血清脂质水平有统计学意义的下降（P<0.05）。相比之下，平均IIEF评分（基线时为24.7±6.4）在随访的6个月和12个月时分别增加到25.0±4.9和26.1±5.9。虽然阿托伐他汀治疗使副交感神经活动增加、交感神经活动减少，但这些变化无统计学意义（P>0.05）。在配对比较中，三个时期的IIEF评分之间存在显著差异（P=0.013）。治疗6个月后差异更明显（IIEF(1vs2)=0.475；IIEF(1vs3)=0.027；IIEF(2vs3)=0.012）。
虽然他汀类药物治疗早期血脂谱有所改善，但勃起功能的恢复出现较晚，这可能归因于血清脂质水平降低使内皮功能得以恢复。
