Pelit Eyyup Sabri, Dokumacı Dilek Şen, Kati Bülent, Yağmur İsmail, Arslan Erkan, Tunçtekin Adem, Kırteke Atakan, Çiftçi Halil, Yeni Ercan
Harran University Faculty of Medicine, Department of Urology, Sanliurfa, Turkey.
Harran University Faculty of Medicine, Department of Radiology, Sanliurfa, Turkey.
Int J Impot Res. 2019 Mar;31(2):139-144. doi: 10.1038/s41443-018-0103-x. Epub 2019 Jan 29.
This study investigated the role of carotid artery intima-media thickness (IMT) as a morphological marker of the response of vasculogenic erectile dysfunction (ED) patients to tadalafil, one of the phosphodiesterase 5 inhibitor (PDE5-I). Through March-December 2016, 51 men with vasculogenic ED aged over 30 years were enrolled in this prospective study. Vasculogenic ED was accepted as a normal testosterone level, with penile colour Doppler ultrasonography showing arteriogenic ED, venogenic ED or mixed arteriogenic and venogenic ED. All patients underwent biochemical and hormonal blood tests, ultrasonographic evaluation of the common carotid artery (CCA) IMT and penile colour Doppler ultrasonography. On-demand tadalafil (10 mg or 20 mg in cases of a non-response to 10 mg) was administered to each patient for 2 months. ED was assessed using the short form of International Index of Erectile Function (IIEF-5) before and after the drug therapy. According to the patients' responses to the medication, they were grouped as non-responders or responders. Thirty-one of the 51 patients responded to tadalafil. The mean CCA IMT of the non-responders and responders was 0.9 ± 0.2 mm and 0.6 ± 0.2 mm, respectively (P = 0.000). The IMT of 90% of the non-responders was >0.67 mm, whereas it was >0.67 mm in 40% of the responders. The data were analysed using the Kolmogorov-Smirnov test, Chi-square test, t-test, Mann-Whitney U test and receiver operator characteristic (ROC) curves. Measurement of CCA IMT may offer an alternative and simple method to predict the response of vasculogenic ED patients to PDE5-Is.
本研究调查了颈动脉内膜中层厚度（IMT）作为血管性勃起功能障碍（ED）患者对磷酸二酯酶5抑制剂（PDE5-I）之一他达拉非反应的形态学标志物的作用。在2016年3月至12月期间，51名年龄超过30岁的血管性ED男性被纳入这项前瞻性研究。血管性ED被定义为睾酮水平正常，阴茎彩色多普勒超声显示动脉性ED、静脉性ED或混合性动脉和静脉性ED。所有患者均接受了生化和激素血液检查、颈总动脉（CCA）IMT的超声评估以及阴茎彩色多普勒超声检查。按需给予每位患者他达拉非（若对10mg无反应则给予20mg），持续2个月。在药物治疗前后使用勃起功能国际指数简表（IIEF-5）评估ED。根据患者对药物的反应，将他们分为无反应者或反应者。51名患者中有31名对他达拉非有反应。无反应者和反应者的平均CCA IMT分别为0.9±0.2mm和0.6±0.2mm（P = 0.000）。90%的无反应者IMT>0.67mm，而40%的反应者IMT>0.67mm。数据采用Kolmogorov-Smirnov检验、卡方检验、t检验、Mann-Whitney U检验和受试者操作特征（ROC）曲线进行分析。测量CCA IMT可能为预测血管性ED患者对PDE5-Is的反应提供一种替代且简单的方法。
