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首页> 外文期刊>The Internet Journal of Anesthesiology >Sildenafil Citrate In Diabetics With Hypertension And Erectile Dysfunction
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Sildenafil Citrate In Diabetics With Hypertension And Erectile Dysfunction

机译：枸酸西地那非与高血压和勃起功能障碍的糖尿病患者

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With the introduction of effective pharmacological agents for treatment of erectile dysfunction, more men are seeking treatment. The underlying cause of the erectile dysfunction is usually a chronic medical illness. (1) Atherosclerosis of the penile artery or the drugs used to reduce cardiovascular risk factors have been implicated in its causation.(2) Sildenafil, acts by activation of nitric oxide (NO)- Cyclic guanosine monophosphate (cGMP) pathway during sexual stimulation. Sildenafil alone can cause mean peak reduction in systolic/diastolic blood pressure of 10/7 mm that are not dose related, where as heart rate remains unchanged. (3) Diabetics with ED do have concomitant hypertension. Many anti hypertensive drugs are known to cause and aggravate ED. Sildenafil is known to reduce blood pressure in healthy adults (3). In one study concomitant use of amlodepine & Sildenafil show synergistic reduction in blood pressure (3). We thought of utilizing sildenafil citrate to treat ED in patients with type 2 diabetes mellitus & note its effect on blood pressure. Subjects And Methods To study the blood pressure lowering effect of sildenafil in male diabetic patients with erectile dysfunction (ED), 68 male patients having type 2 diabetes mellitus were screened in the medical OPD. The baseline data regarding the duration of diabetes, duration of ED was recorded. Complications of diabetes like neuropathy, nephropathy, retinopathy, hypertension and sexual dysfunctions were looked for. Patients without significant hypertension, having postural hypotension, without erectile dysfunction, and those already on anti hypertensive drugs were excluded. 26 Patients with moderate hypertension along with erectile dysfunction were enrolled for the study. All these patients were on oral hypoglycemic agents and had a good control of diabetes. A written consent was taken and they were explained the details of the study as well as the side effects of sildenafil citrate. All these willing patients were then prescribed sildenafil citrate in the dose of 25 mg to be taken once a day at bedtime. The blood pressure was recorded in the OPD at the beginning of the study and after 2 weeks of drug therapy. Two readings were taken 15 minutes apart and the mean of these two readings was recorded on both the occasions. Patients were taught to record their blood pressure. They were then asked to record their blood pressure every other day and bring the record to the OPD at the end of two weeks. This was done to look for any precipitous fall in blood pressure. The improvement in erectile dysfunction was noted by recording patient's response, at the beginning and at the end of 2 weeks, on a scale of 1 to 10 with 1 denoting no erection and 10 denoting adequate erection. The sexual performance satisfaction was also noted on a scale of 1 to 10 with 10 being adequate sexual performance. Results 26 male diabetic patients were enrolled for the study but only 24 were taken up for analysis. Two patients dropped out due to severe adverse effects from day 2 onwards. Mean age was 44 ± 12.5 years. All of them had type 2 diabetes mellitus and were well controlled on oral hypoglycemic agents. Mean Duration of diabetes mellitus 8.5 1.75 years. All of them had moderate hypertension. All the patients enrolled had erectile dysfunction since some time. Mean Duration of erectile dysfunction was 4 ± 1.5 years. Associated complications noted in these patients were background retinopathy in 14, nephropathy, in the form of micro albuminuria in 8 and neuropathy, predominantly sensory (distal symmetrical) in 6. There were no symptomatic macro vascular complications in these patients. The systolic blood pressure was in the range of 150-160 mm Hg (mean SBP 156 4.5 mmHg) and diastolic blood pressure between 100-105 mm Hg (mean DBP 102 2.5 mmHg). Decline in BP was noted from 2nd day onwards. The blood pressure recorded at the end of two week showed a mean decline of –8.5 ±3.5 mm Hg systolic and –5.4
机译：随着治疗勃起功能障碍的有效药物的引入，越来越多的男性正在寻求治疗。勃起功能障碍的根本原因通常是慢性医学疾病。 （1）阴茎动脉的动脉粥样硬化或用于降低心血管危险因素的药物与病因有关。（2）西地那非在性刺激过程中通过激活一氧化氮（NO）-环鸟苷单磷酸（cGMP）途径起作用。单独使用西地那非可导致与剂量无关的收缩压/舒张压平均峰值下降10/7 mm，而心率保持不变。 （3）ED的糖尿病患者确实伴有高血压。已知许多抗高血压药可引起并加重ED。已知西地那非可降低健康成年人的血压（3）。在一项研究中，氨氯地平和西地那非的同时使用显示出血压的协同降低（3）。我们考虑利用枸sil酸西地那非治疗2型糖尿病患者的ED，并注意其对血压的影响。对象和方法为了研究西地那非在男性勃起功能障碍（ED）糖尿病患者中的降压效果，在医学OPD中筛选了68名男性2型糖尿病患者。记录有关糖尿病病程，ED病程的基线数据。寻找糖尿病的并发症，例如神经病，肾病，视网膜病，高血压和性功能障碍。无明显高血压，体位性低血压，无勃起功能障碍的患者和已经服用抗高血压药物的患者被排除在外。本研究招募了26名中度高血压伴勃起功能障碍的患者。所有这些患者均口服降糖药，对糖尿病的控制良好。取得了书面同意，并向他们解释了研究的详细信息以及枸sil酸西地那非的副作用。然后向所有这些愿意的患者开具25 mg枸sil酸西地那非的处方，每天睡前服用一次。在研究开始时和药物治疗2周后，在OPD中记录血压。两次读数间隔15分钟，两次均记录两次读数的平均值。教导患者记录血压。然后要求他们每两天记录一次血压，并在两周末将记录带到OPD。这样做是为了寻找血压的急剧下降。通过在2周开始和结束时以1到10的等级记录患者的反应来记录勃起功能障碍的改善，其中1表示没有勃起，10表示勃起。还以1到10的等级表示对性行为的满意度，其中10分表示足够的性行为。结果26名男性糖尿病患者被纳入研究，但只有24名被纳入分析。从第2天开始，有2名患者由于严重的不良反应而退学。平均年龄为44±12.5岁。他们都患有2型糖尿病，并且口服降糖药得到了很好的控制。平均糖尿病持续时间8.5 1.75年。他们都患有中度高血压。自一段时间以来，所有入选患者均患有勃起功能障碍。勃起功能障碍的平均持续时间为4±1.5年。这些患者的相关并发症为背景性视网膜病变14例，肾病，微蛋白尿形式8例和神经病，6例主要为感觉性（远端对称性），这些患者无症状性大血管并发症。收缩压范围为150-160 mm Hg（平均SBP 156 4.5 mmHg），舒张压范围为100-105 mm Hg（平均DBP 102 2.5 mmHg）。从第二天开始，血压下降。两周结束时记录的血压平均下降幅度为–8.5±3.5 mm Hg收缩压和–5.4

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