一氧化氮神经递质与阴茎勃起关系的临床研究

Clinicalstudy of relationship between nitric oxide and penile erection

目的 探索 Ｎ Ｏ 与阴茎勃起机制的相互关系。方法 自１９９６ 年６ 月至１９９７ 年１２ 月，选取３５ 例勃起功能障碍患者，采用硝普钠进行阴茎海绵体内注射（ Ｉ Ｃ Ｉ） ，分别测定注射前后阴茎外形性状、超声血流动力学变化、阴茎血液 Ｎ Ｏ 含量及血气分析，并选择罂粟碱／ 酚妥拉明进行对照。结果 硝普钠 Ｉ Ｃ Ｉ后：（１） 阴茎外形性状（ 长度、周径、勃起硬度等） 明显改变。（２） 超声显示，在阴茎血流动力学方面，除收缩期峰速度（ Ｓ Ｐ Ｖ） 外，舒张末期流速（ Ｅ Ｄ Ｖ） ，动脉管径（ Ａｄ） ，静脉管径（ Ｖｄ） ，阻力指数（ Ｒ Ｉ） ，两类药物作用效果不存在差异性。（３） 阴茎血液中 Ｎ Ｏ 含量注射后均有所增加，而硝普钠注射后， Ｐ Ｏ２ 增加优于罂粟碱／ 酚妥拉明，ｐ Ｈ 值注射前后无明显变化。结论 Ｎ Ｏ 供体可导致阴茎平滑肌松弛，血窦充盈阴茎勃起，有临床应用价值。

Objective To investigate the relationship of nitric oxide( N O) and penile erection . Methods From June 1996 to Dec .1997 , 35 im potence patients were treated with sodium nitroprusside( S N P) by intracavernousinjection ( I C I) . The following parameters were compared before and after :(1)shape of penis.(2) hemodynamic changes by Doppler ultrasound .(3) change of blood gas analysis and blood N Ocontent. Papaverine/phentolamine was used as controls . Results After I C Iof S N P(1) .the shape ofpenis(length , widith ,erection) changed markedly .(2) .there were nostatiticaldifferences between the twogroups in E D V, Ad , Vd , R Iexcept S P V.(3) after I C I, N Oincreased and the change of P O2 in S N Pgroupwas more marked than thatin controlgroup but no statisical difference was seen before and after I C I. Con clusions The N O donors can facilitate relaxation of penile smoothe muscle,increase of cavernous sinusblood inflow and penile erection . It is considered valuable in clinical treatment for impotence.( Shanghai Med J,1999 ,22 :612 615)