难治性勃起功能障碍的研究进展

Advances in the studies of refractory erectile dysfunction

勃起功能障碍(ED)是一种常见病、多发病。目前主要是首选PDE5抑制剂(PDE5I)治疗,总有效率可达80%,部分患者尤其是伴有糖尿病﹑心血管疾病及前列腺癌根治术后者,单独应用PDE5I效果不佳,称为难治性ED。除了NO-cGMP通路外,勃起与ED的发生过程还涉及多条信号通路(RhoA/Rho激酶、H2S、CO等),复杂的信号网络构成了难治性ED发生的基础,以PDE5I为主的交替治疗、联合治疗等可提高对难治性ED治疗成功率。本文就对PDE5I治疗无效的难治性ED的研究进展作一综述。

[ Abstract] Erectile dysfunction （ED） is a common problem, for which PDE5 inhibitors （PDE5I） represent the first line therapy at present and have a success rate of approximately 80%. Refractory ED, which refers to ED in some patients with chronic diseases such as diabetes mellitus and cardiovascular diseases or in those treated by radical prostatectomy, receives little benefit from PDE5I alone. Apart from the NO-cGMP pathway, the processes of erection and ED involve several signaling pathways, such as RhoA/Rho ki- nase, H2S, CO, etc. The complicated signaling network contributes to the pathogenesis of refractory ED. PDE5I-based alternative therapy and combined therapy may increase the success rate of its treatment. This article outlines the advances in the studies of refrac- tory ED that fails to respond to PDE5I.