Fukumoto Kazuhiko, Nagai Atsushi, Hara Ryoei, Fujii Tomohiro, Miyaji Yoshiyuki
Department of Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Int J Urol. 2017 Mar;24(3):206-210. doi: 10.1111/iju.13273. Epub 2016 Dec 29.
To investigate the effects of tadalafil on vascular endothelial function and cardiovascular risk in patients with prostatic hyperplasia.
Tadalafil 5 mg was given to 20 patients with prostatic hyperplasia for whom an α1-blocker was ineffective. Voiding symptoms and vascular endothelial function were investigated before and after 4 and 12 weeks of administration, using commercial tests for vascular function and vascular endothelial function.
The participants had a median age of 65 years, a mean body mass index of 24.2 and a mean prostate volume of 36.2 mL measured using transabdominal sonography. Voiding symptoms were significantly improved by tadalafil, based on the International Prostate Symptom Score, quality of life index and overactive bladder symptom score (P < 0.05). There were also significant improvements in vascular function (change of brachial-ankle pulse wave velocity from 1701 [before] to 1657 [4 weeks tadalafil] and 1525 [10 weeks tadalafil] cm/s [P < 0.05]) and vascular endothelial function (change of reactive hyperemia index from 1.36 to 1.56 and 1.89 [P < 0.05]). The change in reactive hyperemia index was significantly correlated with International Prostate Symptom Score, quality of life index and brachial-ankle pulse wave velocity.
The improvement in intrapelvic blood flow by tadalafil can result in improved vascular endothelial function, in addition to improvement of voiding symptoms. The change in reactive hyperemia index seems to correlate with the severity of voiding symptoms, with tadalafil being most effective in patients with mild voiding symptoms.
探讨他达拉非对前列腺增生患者血管内皮功能及心血管风险的影响。
对20例使用α1受体阻滞剂无效的前列腺增生患者给予5毫克他达拉非。在给药前以及给药4周和12周后，使用血管功能和血管内皮功能的商用检测方法，对排尿症状和血管内皮功能进行研究。
参与者的中位年龄为65岁，平均体重指数为24.2，经腹部超声测量平均前列腺体积为36.2毫升。根据国际前列腺症状评分、生活质量指数和膀胱过度活动症状评分，他达拉非显著改善了排尿症状（P<0.05）。血管功能（肱踝脉搏波速度从1701[给药前]变为1657[他达拉非治疗4周后]和1525[他达拉非治疗10周后]厘米/秒[P<0.05]）和血管内皮功能（反应性充血指数从1.36变为1.56和1.89[P<0.05]）也有显著改善。反应性充血指数的变化与国际前列腺症状评分、生活质量指数和肱踝脉搏波速度显著相关。
他达拉非改善盆腔内血流，除了改善排尿症状外，还可导致血管内皮功能改善。反应性充血指数的变化似乎与排尿症状的严重程度相关，他达拉非对轻度排尿症状患者最有效。
