CAJ | 학술논문

目的评价肾移植术后受者应用西地那非治疗勃起功能障碍(ED)的有效性和安全性.方法选择192例肾移植术后半年以上,且移植肾功能良好的已婚男性受者进行勃起功能国际问卷(IIEF)调查评分,并以此判定是否患ED.收集受者的一般临床资料、病史和实验室检查资料.首先对ED患者进行心理治疗,未改善者再使用西地那非治疗.治疗4周后再次进行IIEF评分,并检测肝肾功能、血常规、血脂、电解质、血环孢素A或他克莫司的浓度谷值,观察和记录血压变化和药物不良反应.结果 192例肾移植受者中,85例经心理治疗无效的患者使用了西地那非治疗,治疗4周后IIEF评分明显改善,临床总有效率为83.5％.患者血压、血肌酐、血环孢素A或他克莫司浓度谷值无显著性变化(P＞0.05),使用环孢素A者的西地那非用量为(72.4±27.7)mg/次,明显高于使用他克莫司者的西地那非用量(43.7±21.9)mg/次(P＜0.05).使用西地那非后不良反应轻微.结论肾移植术后肾功稳定患者应用西地那非治疗ED有效、安全.使用低剂量的西地那非未对环孢素A或他克莫司的代谢和移植肾功能产生明显影响.
목적 평개신이식술후수자응용서지나비치료발기공능장애(ED)적유효성화안전성.방법 선택192례신이식술후반년이상,차이식신공능량호적이혼남성수자진행발기공능국제문권(IIEF)조사평분,병이차판정시부환ED.수집수자적일반림상자료、병사화실험실검사자료.수선대ED환자진행심리치료,미개선자재사용서지나비치료.치료4주후재차진행IIEF평분,병검측간신공능、혈상규、혈지、전해질、혈배포소A혹타극막사적농도곡치,관찰화기록혈압변화화약물불량반응.결과 192례신이식수자중,85례경심리치료무효적환자사용료서지나비치료,치료4주후IIEF평분명현개선,림상총유효솔위83.5％.환자혈압、혈기항、혈배포소A혹타극막사농도곡치무현저성변화(P＞0.05),사용배포소A자적서지나비용량위(72.4±27.7)mg/차,명현고우사용타극막사자적서지나비용량(43.7±21.9)mg/차(P＜0.05).사용서지나비후불량반응경미.결론 신이식술후신공은정환자응용서지나비치료ED유효、안전.사용저제량적서지나비미대배포소A혹타극막사적대사화이식신공능산생명현영향.
Objective To evaluate the efficacy and safety of sildenafil in these patients with erectile dysfunction (ED) as well as its effects on cylosporine/tacrolimus concentrations and graft function.Method One hundred and ninety-two married males,who had received kidney transplantations at least half a year before and with stable kidney function,were selected randomly in the study.ED was assessed and diagnosed using the self-administered International Index of Erectile Function (IIEF),and those with ED undergoing unsuccessful psychotherapy were treated with sildenafil for 4 weeks.The efficacy of sildenafil was assessed by readministering the IIEF questionnaire after 4 weeks of therapy.Blood pressure,serum creatinine levels,and cyclosporine/tacrolimus trough concentrations were measured before and after sildenafil therapy.Results Eighty-five recipients with ED received sildenafil for 4 weeks.The IIEF scores of each question were increased significantly and sildenafil treatment was effective in 71 patients (83.5％).Blood pressure,serum creatinine levels,and cyclosporine/tacrolimus trough concentrations had no significant change before and after sildenafil treatment.The dosage of sildenafil in recipients with cyclosporine was higher than that of recipients with tacrolimus (72.4 ± 27.7 mg vs.43.7 ± 21.9 mg,P＜0.05).Side effects were slight.Conclusion This study demonstrated that sildenafil treatment for kidney-transplant patients with ED was effective and safe.It is necessary to further study metabolic effects of sildenafil therapy on cyclosporine/tacrolimus.