摘要
目的探讨不同联合降压方案对高血压男性患者勃起功能的影响。方法采用前瞻性随机、平行、对照、固定治疗方案将148名≤60岁男性高血压患者随机分为3组:A组[非洛地平5 mg/d+厄贝沙坦150 mg/d(n=49)],B组[非洛地平5 mg/d+琥珀酸美托洛尔47.5 mg/d(n=46)],C组[非洛地平5 mg/d+氢氯噻嗪12.5 mg/d(n=53)]。治疗4周若血压≥140/90 mm Hg,非洛地平剂量加倍。随访6月。采用国际男性性功能判断指标(IIEF-5)分别于治疗前、后对IIEF-5和血清睾酮、性激素结合球蛋白(SHBG)进行评定。结果治疗后3组降压达标率、有效率组间比较均无统计学差异(均P>0.05)。治疗前、后勃起功能障碍(ED)的总发生率分别为34.46%、35.81%,差异无统计学意义(P>0.05)。3组治疗前后轻、中、重度ED的发生率之间亦无统计学差异。3组治疗前后中、重度ED的IIEF-5评分比较无统计学差异,但A组可提高轻、中度ED患者的IIEF-5评分。3组血清睾酮和SHBG治疗前后比较无统计学差异。结论非洛地平缓释片联合厄贝沙坦片有利于男性高血压轻、中度ED患者性功能的改善。
Objective This study was to assess the effect of different combination antihypertensive therapy on erectile dysfunction（ED） in male hypertensives.Methods A total of 148 male hypertensives aged ≤60 years were enrolled in this prospective randomized controled interventional study,and followed up for 6 months.Patients were divided into 3 groups including Felodipine（5 mg/d）＋Irbesartan（150 mg/d）（A,n=49）,Felodipine（5 mg/d）＋Metoprolol（47.5 mg/d）（B,n=46） and Felodipine（5 mg/d）＋Hydrochlorothiazide（12.5 mg/d）（C,n=53） respectively.Doses of Felodipine were doubled after 4 weeks if blood pressure was ≥140/90 mm Hg.Erectile function was assessed according to the 5-Item version of the international index of erectile dysfunction（IIEF-5） questionnaire.Blood samples were taken for assessing the testosterone（T） and the sex hormone binding globulin（SHBG）.Results There were a significant blood pressure decrease in all 3 groups（P〈0.01） and no difference（P〉0.05） among these 3 groups.There was no statistically significant difference of total prevalence of ED between before and after treatment,with prevalence rate of 34.46% and 35.81%.An improvement of sexual function was noted in the patients with mild to moderate sexual dysfunction in group A.There was no significant difference of sexual function between group A and B.There were some changes of the testosterone and SHBG between groups before and after treatment in 6 months follow up（P〉0.05）.Conclusion Combination therapy is effective to lowing blood pressure of hypertensive.Combination of treatment of Felodipine ＋Irbesartan seems be better to prevent the ED in male hypertensives with mild to moderate sexual dysfuntion.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2010年第4期365-369,共5页
Chinese Journal of Hypertension
基金
甘肃省技术研究与开发专项计划(0709TCYA068)
关键词
高血压
勃起功能
非洛地平
厄贝沙坦
琥珀酸美托洛尔
氢氯噻嗪
Hypertension
Erectile function
Felodipine
Irbesartan
Metoprolol succinct extended release
Hydrochlorothiazide
