西地那非治疗2型糖尿病患者勃起功能障碍疗效分析

Efficacy of Sildenafil citrate in the treatment of type 2 diabetes mellitus patients with erectile dysfunction

目的评价西地那非治疗2型糖尿病（DM）患者勃起功能障碍（ED）的临床疗效。方法门诊筛查ED患者，符合入选标准及排除标准的ED并伴有2型DM患者42例作为实验组，另于门诊选择同期无DM的单纯ED患者40例作为对照组。按需给予西地那非治疗，3个月后随访，完善疗效评价量表。结果实验组患者用药后IIEF-5评分，显著高于用药前两者比较差异有统计学意义（P〈0．01）。全球疗效问题阳性答复百分率为76．2％。与对照组患者相比差异无统计学意义（P〉0．05）。实验组患者按糖化血红蛋白水平（HbAlC）及DM病程（D）分为4组，其中HbAlC〉7，D〉5年组患者用药后IIEF-5评分为（16.00±0．82），用药前为（13．14±353），用药前后比较，差异具统计学意义（P〈0．05）。GEQ阳性答复率为42．9％，与对照组相比，差异具统计学意义（P〈0.05）。结论西地那非治疗2型DM患者伴ED疗效确切。但伴有DM并发症的ED患者，效果欠佳。

Objective To evaluate the efficacy of Sildenafil citrate in the treatment of type 2 diabetes mellitus patients with erectile dysfunction. Methods A total of 42 type 2 diabetes mellitus patients with ED and 40 ED patients without diabetes mellitus were enrolled in this study. Patients in two groups had age-match and ED clinical grade-match, who treated with sildenafil, the clinical efficacy of sildenafil was evaluated after three months. Results After treatment, the mean scores of IIEF-5 in the experiment group were significantly higher than that before treatment. There was a marked improvement in achieving and maintaining an erection for patients in the experiment group. The proportion of affirmative responses to Global Efficacy Question （GEQ） was 76.2%. There were no differences in items between the ED patients with and without diabetes. Type 2 diabetes patients with ED were subdivided into four groups by HbA1 c level and diabetic course. The efficacy was significantly decreased in patients of subgroup with HbA1 c〉7 and D〉5 compared with that of the control group, but the efficacy was similar between the other subgroups and the case control group. Conclusion Sildenafil was effective in improving erectile dysfunction for type 2 diabetes patients with ED. But efficacy of Sildenafil was decreased for patients with poor glycaemic control and long diabetic duration, especially with diabetic complications, It might be associated with the irreversible endothelial destruction, which need to be further investigation.