高同型半胱氨酸血症与勃起功能障碍研究进展

Hyperhomocysteinemia and erectile dysfunction:An update

高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)是心血管疾病的一个重要危险因素之一。流行病学研究表明勃起功能障碍(ED)与心血管疾病的发生密切相关。HHcy可能是ED的一个新的独立危险因素,HHcy导致ED的机制尚不十分清楚,可能与血管内皮细胞损伤、活性氧(ROS)、动脉粥样硬化等有关。HHcy与ED的关系仍需进一步研究,检测血浆Hcy和叶酸水平以及亚甲基四氢叶酸还原酶(MTHFR)基因型有助于ED诊断,尤其是对于年轻患者以及有心血管病家族史患者。对于HHcy伴ED患者的治疗,可先通过单独服用叶酸或结合维生素B6和维生素12来降低Hcy水平,然后进行5型磷酸二酯酶抑制剂(PDE5i)的治疗。本文就HHcy与ED的研究进展作一综述。

Hyperhomocysteinemia（HHcy） is considered to be one of the most important cardiovascular risk factors.Epidemiological studies conducted on erectile dysfunction（ED） have demonstrated its close correlation with cardiovascular disease,and therefore HHcy might be a novel risk factor of ED.However,the mechanism of ED resulting from HHcy is not precisely known,but may relate to increased damage of vascular endothelial cells,reactive oxygen species（ROS）,and artherosclerosis.Although further studies are needed on this association between HHcy and ED,the measurement of plasma Hcy and folic acid levels and molecular analysis of the MTHFR genotype might be added to the ED diagnostic procedure,especially in young patients or in those with a family history of cardiovascular disease.Treatment of ED patients with HHcy should first aim to reduce the Hcy level through administration of folic acid,alone or in combination with vitamin B6 or B12,and then proceed to treatment with PDE5i.This paper offers an overview on the advances in the studies of the correlation between HHcy and ED.