西地那非联合视听性刺激诱发阴茎勃起的血流动力学初步研究

Study on the hemodynamic parameters of the erection penis evoked by Sildenafil combined with audio-visual sexual stimulation

目的：研究西地那非联合视听性刺激诱发心理性ED患者勃起后的阴茎血流动力学参数变化。方法选择心理性ED患者20名，口服枸橼酸西地那非100mg，15min后给予视听性刺激。在阴茎疲软状态下、口服枸橼酸西地那非后30min、45min、60min、75min和自觉达到最佳勃起状态时，采用多普勒超声检测阴茎海绵体动脉收缩期峰值流速（PSV）、舒张期末最低流速（EDV）、阻力指数（RI）、动脉血管管径（Ad）及其扩张程度（E-Ad）。结果所有受试者均顺利完成检测，服药前疲软状态下、服药后30min、45min、60min、75min和自觉达到最佳勃起状态时海绵体动脉PSV平均值分别为（10.92±2.92）cm/s、（23.28±5.45）cm/s、（37.10±5.13） cm/s、（35.45±6.34）cm/s、（28.77±4.98）cm/s、（33.83±7.14）cm/s，EDV的平均值分别为0cm/s、（2.49±1.89） cm/s、（-2.15±1.69）cm/s、（-1.98±1.85）cm/s、（0.65±1.13）cm/s、（-2.82±1.92）cm/s；RI平均值分别为1、0.89±0.18、1.06±0.21、1.05±0.24、0.98±0.15、1.08±0.29；Ad平均值分别为（0.79±0.13）mm、（0.97±0.12）mm、（1.02±0.14）mm、（1.05±0.09）mm、（1.08±0.20）mm、（1.04±0.11）mm，勃起后各时间点参数值与疲软状态下均存在显著统计学差异，服药后45min和60min时阴茎勃起最充分，该时间点各参数不存在显著统计学差异。结论西地那非联合视听性刺激可诱发阴茎充分勃起，服药后45min及60min勃起最充分，此时行彩色多普勒超声检测阴茎血流动力学参数最具临床应用价值。

Objective To study the hemodynamic parameters of erection penis in psychogenic ED patients evoked by Sildenafil combined with audio-visual sexual stimulation.Methods Total of 20 psychogenic ED patients were first adminstrated orally with 100 mg sildenafil citrate. Fifteen minutes later, they were further stimulated by audio and visual sexual stimulation. The PSV（artery systolic peak flow velocity）, EDV（diastolic ending minimum velocity）, RI （resistance index）, degree of artery diameter （Ad） and E-Ad （expansion） were measured respectively by doppler ultrasound, under weak penis, 30 minutes, 45 minutes, 60 minutes, 75 minutes after oral sildenafil citrate and best erectile state.Results All subjects complete detection. Average cavernosum arteries PSV averages at weak condition before taking the medicine, 30 minutes, 45 minutes, 60 minutes, 75 minutes after treatment, and consciously achieving best an erection were （10.92±2.92） cm/s, （23.28±5.45）cm/s, （37.10±5.13）cm/s, （35.45±6.34）cm/s, （28.77±4.98）cm/s and （33.83±7.14）cm/s respectively; Average EDV were 0cm/s, （2.49±1.89）cm/s, （-2.15±1.69）cm/s, （-1.98±1.85）cm/s, （0.65±1.13）cm/s, （-2.82±1.92）cm/s; Average RI were 1, 0.89±0.18, 1.06±0.21, 1.05±0.24, 0.98±0.15, 1.08±0.29; the mean value of Ad were （0.79±0.13）mm, （0.97±0.12）mm, 1.02±0.14mm, 1.05±0.09mm, 1.08±0.20mm and 1.04±0.11mm. Between erect after parameter values at each time point and the weak state, there were statistically significant differences （P〈0.05）. Penile erectile was most fully at 45 minutes and 60 minutes after taking the drug, and there was no statistically significant difference at this time point between each parameter. Conclusion Sildenafil together with audio-visual sexual can evoke a full erection of the penis. The best time points of completely erecting were 45- minutes and 60 - minutes after taking sildenafil. At these two time points, the hemodynamic parameters obatined from color doppler ultrasonic had most clinical value.