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首页> 外文期刊>Journal of Andrology >Erectile dysfunction: a harbinger or consequence: does its detection lead to a window of curability?
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Erectile dysfunction: a harbinger or consequence: does its detection lead to a window of curability?

机译：勃起功能障碍：预兆或后果：发现勃起功能障碍是否可治愈？

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Erectile dysfunction (ED) is a marker of increased cardiovascular (CVS) risk and may indicate the need for aggressive evaluation for cardiovascular disease (CVD). In younger men with ED, the Framingham risk assessment has inadequate sensitivity. There is a need to develop a more sensitive risk-stratification protocol for this population. We sought to develop an algorithm for the evaluation and management of the ED patient. A search of literature published from 1998 to 2009 was performed. Search terms included the following: endothelial dysfunction; and erectile dysfunction combined with coronary artery disease (CAD), metabolic syndrome, or cardiac biomarkers. Searches revealed 107 references. These studies were evaluated with use of levels of evidence for the Centers of Evidence-Based Medicine. On the basis of these studies, recommendations for the evaluation and management of the patient with ED were developed. Newer, nontraditional markers and procedures may identify ED patients at risk for subsequent CVS events earlier or more easily than traditional risk assessments. Clear practice guidelines for risk stratification are being developed, and data are sufficient to propose an algorithm for these patients. The presence of ED should prompt assessment of cardiac risk and aggressive risk factor treatment. Available risk assessment factors should initially be used to stratify each patient. ED patients younger than 60 years of age and with no clinical CVD are at risk of CAD events (>10%) and should undergo further risk assessment. Additional tests of arterial damage and biomarkers may aid in refinement of risk for future cardiac events. Patients with ED can be classified into low-, intermediate-, and high-risk categories. A proposed algorithm can be used to direct the assessment of cardiometabolic risk in patients with ED.
机译：勃起功能障碍（ED）是心血管（CVS）风险增加的标志，可能表明需要积极评估心血管疾病（CVD）。对于患有ED的年轻男性，Framingham风险评估的敏感性不足。有必要为该人群开发更敏感的风险分层方案。我们试图开发一种用于评估和管理ED患者的算法。检索1998年至2009年出版的文献。搜索词包括以下内容：内皮功能障碍;勃起功能障碍并合并冠状动脉疾病（CAD），代谢综合征或心脏生物标志物。搜索发现107篇参考文献。这些研究是使用循证医学中心的证据水平进行评估的。在这些研究的基础上，提出了评估和治疗ED患者的建议。与传统的风险评估相比，较新的非传统标记和程序可以更早或更轻松地识别出有随后CVS事件风险的ED患者。正在为风险分层制定清晰的实践指南，并且数据足以为这些患者提出一种算法。 ED的存在应及时评估心脏风险和积极的危险因素治疗。首先应使用可用的风险评估因素对每位患者进行分层。年龄小于60岁且无临床CVD的ED患者有发生CAD事件的风险（> 10％），应接受进一步的风险评估。动脉损伤和生物标志物的其他测试可能有助于改善未来心脏事件的风险。 ED患者可分为低，中和高风险类别。提出的算法可用于指导ED患者的心脏代谢风险评估。

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