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目的:探讨5型磷酸二酯酶抑制剂(PDE5i)对辅助生殖技术(ART)中偶发阴茎勃起功能障碍(ED)的治疗价值。方法:2008年3月至2012年6月行ART治疗的因偶发性ED而发生取精困难的患者75例,给予口服PDE5i(西地那非、他达拉非、伐地那非)的方法进行治疗,采用勃起硬度分级(EHS)法对患者的勃起程度进行评价,对患者获取精液的成功率进行分析。结果:75例患者中,有28例、25例和22例分别服用西地那非、他达拉非和伐地那非,61例(81.3%)服药后有效勃起,其中西地那非24例,他达拉非20例,伐地那非17例,有效率分别为85.7%、80.0%和77.3%,三者比较差异无统计学意义(P>0.05)。75例患者中有53例(70.7%)服药后有效勃起并成功获取精液,其中西地那非21例,他达拉非17例,伐地那非15例,成功率分别为75.0%、68.0%和68.2%,三者比较差异无统计学意义(P>0.05)。75例患者中有37例和38例分别服用PDE5i一般推荐剂量(半量)和最大推荐剂量(全量),分别有28例和25例获取精液成功,成功率分别为75.7%和65.8%,两者相比差异无统计学意义(P>0.05)。75例患者中有5例(6.7%)服药后出现轻度一过性的颜面潮红、头晕等药物不良反应。结论:3种PDE5i均能帮助偶发性ED患者有效勃起并成功获取精液,是治疗ART中突发性取精困难患者的一种安全有效的药物。
Objective: To investigate the therapeutic value of type 5 phosphodiesterase inhibitor (PDE5i) on incident erectile dysfunction (ED) in assisted reproductive technology (ART). Methods: From March 2008 to June 2012, 75 patients with dysphagia who underwent ART due to incidental ED were treated with oral PDE5i (sildenafil, tadalafil, vardenafil) The erectile stiffness classification (EHS) method was used to evaluate the erectile degree of the patients and the success rate of semen acquisition was analyzed. Results: Of the 75 patients, 28 were euthanized and 25 (22) and 22 (22) were treated with sildenafil, tadalafil and vardenafil, respectively. 61 (81.3% For example, tadalafil 20 cases, vardenafil 17 cases, the effective rates were 85.7%, 80.0% and 77.3%, respectively, there was no significant difference between the three (P> 0.05). Of the 75 patients, 53 (70.7%) erectile successfully ejaculate and successfully obtained semen, including 21 cases of sildenafil, 17 cases of tadalafil and 15 cases of vardenafil, the success rates were 75.0%, 68.0 % And 68.2% respectively. There was no significant difference among the three (P> 0.05). Thirty-seven (75%) and 38 (75%) patients received the PDE5i recommended dose (half dose) and the maximum recommended dose (full dose), respectively. Twenty-eight and 25 patients achieved semen success, with success rates of 75.7% and 65.8%, respectively Compared with no significant difference (P> 0.05). Five of the 75 patients (6.7%) developed mild transient flushing and dizziness with adverse drug reactions. CONCLUSION: All three PDE5i can help erectile dysfunction in patients with sporadic ED and obtain semen successfully. It is a safe and effective drug for the treatment of patients with sudden dysmenorrhea in ART.