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首页> 外文期刊>The journal of sexual medicine >Treating Erectile Dysfunction and Central Neurological Diseases with Oral Phosphodiesterase Type 5 Inhibitors. Review of the Literature
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Treating Erectile Dysfunction and Central Neurological Diseases with Oral Phosphodiesterase Type 5 Inhibitors. Review of the Literature

机译：用口服磷酸二酯酶5型抑制剂治疗勃起功能障碍和中枢神经系统疾病。文献回顾

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Introduction. Erectile dysfunction (ED) is reported in a high percentage of patients with central neurological disorders (CND). Aim. An up-to-date review on oral phosphodiesterase 5 inhibitors (PDE5): sildenafil, tadalafil, and vardenafil for individuals with CND and ED. Main Outcome Measures. Various questionnaires on ED, such as the International Index of Erectile Function composed of 15 questions. Methods. Internationally published clinical studies evaluating the efficacy and safety of PDE5 on subjects with CND and ED were selected. Results. Overall, 28 articles on PDE5 used to treat patients with CND and ED were included. With each of the three PDE5 compared to placebo or erectile baseline, literature reported significant statistical improvement (P<0.01; P<0.05) only in patients with spinal cord injury (SCI). PDE5 efficacy was documented for SCI patients up to 10 years. The most frequent predicable factor for PDE5 success was the presence of upper motoneuron lesion. Each of the three clinical sildenafil studies documented statistically significant improvement on erectile function in Parkinson's patients (P<0.01; P<0.05). Two studies reported discordant results about sildenafil's effectiveness on multiple sclerosis (MS) patients; one on tadalafil showed significant statistical efficacy on erection versus baseline (P<0.01; P<0.05). The only spina bifida article determined that sildenafil remarkably improved erectile function. Overall, drawbacks were mostly slight-moderate, except in subjects with multiple system atrophy where sildenafil caused severe hypotension. Conclusions. PDE5 represent first line ED therapy only for SCI patients, though treatment results through meta-analysis were not possible. Encouraging results are reported for Parkinson's and MS patients. PDE5 use for other CND patients is limited for various reasons, such as ED and concomitant libido impairment caused by depression and/or sexual endocrinology dysfunctions, and because PDE5 may cause a worsening of neurological illness. Medical centers staffed by health professionals able to counsel patients on the possible use of PDE5 are needed.
机译：介绍。据报告，患有中枢神经系统疾病（CND）的患者中勃起功能障碍（ED）的比例很高。目标。口服磷酸二酯酶5抑制剂（PDE5）的最新综述：西地那非，他达拉非和伐地那非用于CND和ED患者。主要观察指标。有关ED的各种问卷，例如由15个问题组成的国际勃起功能指数。方法。选择国际评估PDE5对CND和ED受试者的疗效和安全性的临床研究。结果。总体而言，包括用于治疗CND和ED患者的PDE5的28篇文章。与安慰剂或勃起基线相比，这三种PDE5的每一种，文献报道仅在脊髓损伤（SCI）患者中统计学显着改善（P <0.01; P <0.05）。据记录，SDE患者长达10年的PDE5疗效。 PDE5成功的最常见可预测因素是上运动神经元病变的存在。三项临床西地那非研究均记录了帕金森氏病患者勃起功能的统计学显着改善（P <0.01; P <0.05）。两项研究报告了西地那非对多发性硬化症（MS）患者有效性的不一致结果。他达拉非的一项研究显示，其勃起与基线相比有显着的统计学疗效（P <0.01; P <0.05）。脊柱裂的唯一文章确定西地那非显着改善了勃起功能。总体而言，除多西非那非引起严重低血压的多系统萎缩的受试者外，其缺陷大多为中度。结论。尽管无法通过荟萃分析获得治疗结果，但PDE5仅代表SCI患者的一线ED治疗。据报道，对于帕金森氏症和MS患者，结果令人鼓舞。由于各种原因，PDE5在其他CND患者中的使用受到限制，例如ED和伴随的抑郁症和/或性内分泌功能障碍引起的性欲减退，以及PDE5可能导致神经疾病恶化。需要由能够向患者提供PDE5可能使用咨询服务的医疗专业人员的医疗中心。

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