Arena F, Peracchia G, Di Stefano C, Passari A, Larosa M, Cortellini P
Divisione di Urologia Azienda Ospedaliera di Parma.
Acta Biomed Ateneo Parmense. 1995;66(6):269-72.
Calcium antagonist increase extracellular matrix collagenase activity as well as decrease collagen, fibronectin synthesis and secretion, altering fibroblastic metabolism. Preliminary findings reports that Verapamil improves would healing; Levine (1994) suggest that intralesional calcium antagonist (Verapamil) therapy offers an economical and sensible non operative approach for the treatment of Peyronie's disease. We studied and verified the effect of Verapamil in Peyronie's plaque on 39 men. They received injections of Verapamil bi-weekly in to the plaques for 6 months. Subjectively, improvement in rigidity was observed in 23,1% and a plaque softening observed in 48,7%. Rapid resolution of pain was verified in 90,9%. Objectively, curvature improved in 50% of those in which the diagnosis of Peyronie's disease was less than one year old, but in only 10.2% when disease lasted more than one year. A decreased plaque volume was not observed. There was no toxicity related to Verapamil effect. In this nonrandomized study we retained that Verapamil appears to result in an improvement in patients with symptoms lasting less than one year. For patients without pain with symptoms related to more than one year, Verapamil had no important effect.
钙拮抗剂可增加细胞外基质胶原酶活性，同时减少胶原蛋白、纤连蛋白的合成与分泌，从而改变成纤维细胞的代谢。初步研究结果报告称维拉帕米可促进伤口愈合；莱文（1994年）指出，病灶内注射钙拮抗剂（维拉帕米）疗法为佩罗尼氏病的治疗提供了一种经济且合理的非手术方法。我们对39名男性进行了研究，以验证维拉帕米对佩罗尼氏斑块的疗效。他们每两周接受一次维拉帕米斑块内注射，持续6个月。主观上，23.1%的患者阴茎硬度有所改善，48.7%的患者斑块出现软化。90.9%的患者疼痛迅速缓解。客观上，佩罗尼氏病诊断时间小于1年的患者中，50%的患者阴茎弯曲度有所改善，但病程超过1年的患者中只有10.2%得到改善。未观察到斑块体积减小。未发现与维拉帕米作用相关的毒性。在这项非随机研究中，我们认为维拉帕米似乎能使症状持续时间小于1年的患者病情得到改善。对于无症状超过1年的患者，维拉帕米没有显著效果。
