Burnett Arthur L, Strong Travis D, Trock Bruce J, Jin Liming, Bivalacqua Trinity J, Musicki Biljana
Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
J Urol. 2009 Jan;181(1):245-51. doi: 10.1016/j.juro.2008.09.005. Epub 2008 Nov 14.
We investigated changes in serum biomarkers of vascular function after short-term, continuous sildenafil dosing in men with type 2 diabetes with erectile dysfunction.
Men with erectile dysfunction associated with type 2 diabetes mellitus were randomized to receive continuous, daily sildenafil (50 mg for 1 week run-in and 100 mg for 3 weeks) (148), or placebo (144) for 4 weeks (phase I) and then sildenafil (25, 50 or 100 mg) on demand for 12 weeks (phase II). Blood draws at baseline and after phases I and II were analyzed for cyclic guanosine monophosphate (endothelial function marker), 8-isoprostane (oxidative stress marker), and interleukin-6 and interleukin-8 (inflammatory cytokines). Primary and secondary erectile function outcome variables were affirmative responses on Sexual Encounter Profile question 3 (ability to maintain erection sufficient for sexual intercourse) and Erection Hardness Score, respectively.
Serum cyclic guanosine monophosphate levels were increased in the sildenafil group relative to the placebo group at 4 (p <0.01) and 16 (p <0.05) weeks, correlating with affirmative responses to Sexual Encounter Profile question 3 at the 4-week interval only (p <0.05). Serum 8-isoprostane levels were decreased to a nonsignificant degree in the sildenafil group at 4 weeks with no further change at 16 weeks, whereas interleukin-6 and interleukin-8 levels were unchanged at either interval, and these levels were unassociated with erectile function outcomes.
These data suggest that short-term, continuous sildenafil treatment causes systemic endothelial function to be enhanced and remain so for a duration after its discontinuation. However, they do not indicate any influence of this treatment on systemic oxidative stress or inflammation, or an effect on long-term erectile function improvement.
我们研究了短期连续服用西地那非后，2型糖尿病伴勃起功能障碍男性血管功能血清生物标志物的变化。
将2型糖尿病伴勃起功能障碍的男性随机分为两组，一组连续每日服用西地那非（第1周服用50mg进行导入期，接下来3周服用100mg）（148例），另一组服用安慰剂（144例），为期4周（I期），然后按需服用西地那非（25mg、50mg或100mg），为期12周（II期）。在基线期以及I期和II期结束后采集血液，分析环磷酸鸟苷（内皮功能标志物）、8-异前列腺素（氧化应激标志物）、白细胞介素-6和白细胞介素-8（炎性细胞因子）。主要和次要勃起功能结局变量分别为性接触概况问题3的肯定回答（维持足够性交勃起的能力）和勃起硬度评分。
与安慰剂组相比，西地那非组在第4周（p<0.01）和第16周（p<0.05）时血清环磷酸鸟苷水平升高，仅在第4周时与性接触概况问题3的肯定回答相关（p<0.05）。西地那非组在第4周时血清8-异前列腺素水平有非显著性降低，第16周无进一步变化，而白细胞介素-6和白细胞介素-8水平在两个时间点均无变化，且这些水平与勃起功能结局无关。
这些数据表明，短期连续服用西地那非可增强全身内皮功能，并在停药后持续一段时间。然而，这些数据并未表明该治疗对全身氧化应激或炎症有任何影响，也未表明对长期勃起功能改善有作用。
