N‑乙酰半胱氨酸在难治性勃起功能障碍中的应用

Application of N-acetylcysteine in refractory erectile dysfunction

勃起功能障碍(ED)是男科门诊中常见的疾病。虽然5-型磷酸二酯酶抑制剂已经可以使70%的ED患者勃起功能得到显著改善,但其对难治性ED(包括老年性ED、糖尿病性ED以及阴茎海绵体神经损伤性ED)疗效欠佳或无效。因此,寻找理想的难治性ED干预方式,成为了男科学领域的难点。既往研究表明,N-乙酰半胱氨酸(NAC)不仅在溶解呼吸道黏液和对乙酰基氨基酚过量所致肝毒性解救方面作用明显,在心血管疾病、肿瘤、泌尿男科疾病方面也具有多种功效。本文围绕NAC的抗氧化、抗炎以及其对一氧化氮的调控和抗纤维化作用在难治性ED中可能产生的效应作一综述,以此展望NAC在难治性ED干预中的应用前景。

Erectile dysfunction(ED)is a common disease in andrology clinics.Although oral type 5 phosphodiesterase inhibitors have significantly improved erectile function in 70%of ED patients,the therapeutic effect of them in refractory ED(including aging-related ED,diabetes mellitus-related ED,and ED induced by corpus cavernous nerve injury)is not good or even they have no effects at all.Therefore,exploring an ideal intervention scheme for refractory ED has become a difficult problem in the field of andrology.Previous studies have shown that N-acetylcysteine(NAC)not only plays a significant role in respiratory mucolysis and detoxification of liver toxicity caused by acetylaminophenol overdose,but also has a variety of effects on cardiovascular diseases,tumors,and urological and andrological diseases.This article reviewed the antioxidant and anti-inflammatory effects,as well as its regulation of nitric oxide and anti-fibrosis effects of NAC in refractory ED,in order to evaluate the application prospect of NAC in the treatment of refractory ED.