Akand M, Gencer E, Yaman Ö, Erişgen G, Tekin D, Özdiler E
Department of Urology, School of Medicine, Selcuk University, Konya, Turkey.
Department of Physiology, School of Medicine, Bülent Ecevit University, Zonguldak, Turkey.
Andrologia. 2015 Dec;47(10):1098-102. doi: 10.1111/and.12387. Epub 2014 Dec 8.
To investigate the effect of sildenafil on platelet function and cyclic guanosine monophosphate (cGMP) levels in patients with erectile dysfunction, we evaluated the association between erectile function and platelet responses after administration of 100 mg sildenafil. Erectile responses were monitored after 8 daily doses of the drug. Adenosine diphosphate (ADP) and collagen-induced platelet aggregation and simultaneous adenosine triphosphate (ATP) release and cGMP levels were determined before and after sildenafil therapy. Basal levels for platelet aggregation, ATP release and cGMP were compared with age-matched controls. There was no difference among basal levels of platelet responses between patients and controls, except for ADP-induced platelet aggregation (P = 0.04). It was significantly higher in the patient group. Analysis of the responses to sildenafil revealed that for the patients who showed a positive erectile response, there was a significant increase in platelet cGMP (P = 0.028) and a decrease in ADP-induced platelet aggregation (P = 0.04). However, for those who showed a negative or poor erectile response, there was no change in platelet cGMP levels and platelet functions. Sildenafil did not affect collagen-induced platelet responses although cGMP levels of the responders increased. It is concluded that sildenafil increases platelet cGMP in the patients with positive erectile response. Therefore, it has been speculated that platelet cGMP may be used as an index for erectile response.
为研究西地那非对勃起功能障碍患者血小板功能及环磷酸鸟苷（cGMP）水平的影响，我们评估了服用100mg西地那非后勃起功能与血小板反应之间的关联。在每日服用该药物8次后监测勃起反应。在西地那非治疗前后测定二磷酸腺苷（ADP）和胶原诱导的血小板聚集以及同时发生的三磷酸腺苷（ATP）释放和cGMP水平。将血小板聚集、ATP释放和cGMP的基础水平与年龄匹配的对照组进行比较。患者和对照组之间血小板反应的基础水平除ADP诱导的血小板聚集外无差异（P = 0.04）。患者组中该指标显著更高。对西地那非反应的分析显示，对于出现阳性勃起反应的患者，血小板cGMP显著增加（P = 0.028），ADP诱导的血小板聚集减少（P = 0.04）。然而，对于那些出现阴性或不良勃起反应的患者，血小板cGMP水平和血小板功能没有变化。尽管反应者的cGMP水平升高，但西地那非不影响胶原诱导的血小板反应。得出的结论是，西地那非可使有阳性勃起反应的患者血小板cGMP增加。因此，据推测血小板cGMP可作为勃起反应的一个指标。
