Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
Chin Med J (Engl). 2011 Jan;124(2):210-4.
Targeted therapy for erectile dysfunction (ED) involves fewer screening tests and provides a variety of treatment choices for patients. Although the advantage of targeted therapy in diagnosis and therapy for ED has been recognized, the rational mode for oriented ED therapy has not been established. This study aimed to investigate targeted diagnosis and therapy for ED.
A total of 198 patients with ED were included in the study. After intracavernosal vasoactive agent injection was given, color Doppler flow imaging was performed and penile rigidity was classified as Schramek grade 5 (10 minutes duration), grade 4 (10 minutes duration), grade 3 and grade 2, defining four patient groups as group V (143 cases), group IV (23 cases), group III (18 cases), and group II (14 cases). Appropriate and acceptable treatment was recommended to patients according to erection grade.
In 198 patients with ED, the peak systolic velocity, end diastolic velocity, and resistance index in the cavernosal artery and dorsal artery and the flow velocity in the deep dorsal vein were not significantly different before injection (P > 0.05). After injection, peak systolic velocity, end diastolic velocity, and resistance index in the cavernosal artery were different among the four groups (P < 0.05). Between each two groups, the difference in resistance index was significant (P < 0.05). The statistical differences in other indexes were not significant (P > 0.05). Selective targeted therapy based on erection grade by color Doppler flow imaging improved the clinical satisfaction rate to 91.91% (182/198).
Based on the routine diagnosis of ED, blood flow indexes in the cavernosal artery are measured by color Doppler flow imaging following minimally invasive intercavernosal injection, which is combined with the Schramek grade of erection. The most appropriate and acceptable treatment is recommended according to the different groups, which improves the clinical satisfaction of treatment for ED and is an ideal model of targeted diagnosis and treatment.
勃起功能障碍（ED）的靶向治疗涉及较少的筛查测试，并为患者提供多种治疗选择。尽管靶向治疗在 ED 的诊断和治疗方面的优势已得到认可，但针对 ED 靶向治疗的合理模式尚未建立。本研究旨在探讨 ED 的靶向诊断和治疗。
共纳入 198 例 ED 患者。在阴茎海绵体内血管活性药物注射后，行彩色多谱勒血流成像，将阴茎硬度分为 Schramek 5 级（持续 10 分钟）、4 级（持续 10 分钟）、3 级和 2 级，将 4 组患者定义为 V 组（143 例）、IV 组（23 例）、III 组（18 例）和 II 组（14 例）。根据勃起程度向患者推荐适当和可接受的治疗。
198 例 ED 患者，注药前阴茎海绵体动脉、背动脉收缩期峰值流速、舒张末期流速、阻力指数及阴茎深背静脉血流速度比较，差异均无统计学意义（P＞0.05）。注药后，4 组患者阴茎海绵体动脉收缩期峰值流速、舒张末期流速、阻力指数比较，差异均有统计学意义（P＜0.05），两两比较，差异均有统计学意义（P＜0.05）。其他指标差异均无统计学意义（P＞0.05）。基于彩色多谱勒血流成像勃起分级的选择性靶向治疗，临床总满意度为 91.91%（182/198）。
在 ED 常规诊断的基础上，通过微创阴茎海绵体内注射，结合勃起的 Schramek 分级，应用彩色多谱勒血流成像测量阴茎海绵体动脉血流指数，根据不同分组推荐最适宜、最可接受的治疗方法，提高 ED 治疗的临床满意度，是一种理想的靶向诊断和治疗模式。
