磷酸二酯酶Ⅴ型抑制剂治疗下尿路症状的基础与临床研究

The Basic and Clinical Research of Phosphodiesterase-5 Inhibitors in the Treatment of Lower Urinary Symptoms

勃起功能障碍和下尿路症状之间存在独立相关性。两者的相互影响机制一般认为主要与一氧化氮/一氧化氮合酶的变化、自主神经系统过度活动、RhoA/Rho激酶及内皮素通道的影响和盆腔动脉硬化症四个方面有关。磷酸二酯酶Ⅴ型抑制剂可通过对逼尿肌、尿道及前列腺部平滑肌产生舒张效应从而改善膀胱出口部梗阻,单独应用或联合α-受体阻滞剂能有效改善下尿路患者的症状及生活质量评分,联合应用效果更佳。

There is an independent association between lower urinary tract symptoms and erectile dysfunction.Four pathophysiologies have been suggested to explain the relationship：alteration in nitric oxide/nitric oxide synthase levels,autonomic hyperactivity,changes in the Rho-kinase/endothelin pathway and pelvic vasculature atherosclerosis.The action of PDE-5 inhibitors in lower urinary tract symptoms is the relaxation effects of detrusor,urinary and prostate smooth muscle.Clinical studies of the applications（alone or combination with alpha blocker inhibitor）of PDE-5 inhibitors have shown the improvements of symptoms score and quality of life in lower urinary tract symptoms in men with significant problems.Studies have also shown that the greatest improvements occurred with the combination of an alpha blocker and PDE-5 inhibitors when compared with either drug alone.