目的：为评估勃起功能障碍（ED）与内皮功能水平关系，检测了外周循环血管内皮祖细胞（EPCs）、内皮细胞微粒（EMPs）等指标，比较长期小剂量西地那非治疗前后内皮功能的变化。方法：纳入健康男性30例，泌尿外科就诊的ED患者60例。ED患者予25 mg口服西地那非3个月，进行国际勃起功能指数（IIEF-5）和勃起硬度等级（EHGS）评估，并做EPCs、EMPs采用流式细胞术检测等，评估两组内皮功能水平，比较西地那非持续小剂量治疗前后ED患者的内皮功能变化。结果：治疗后ED组IIEF-5明显低于对照组(10.5±4.9 vs 23.7±1.0)、EHGS明显低于对照组(2.3±0.8 vs 3.9±0.5)（P＜0.05）；外周循环EPCs数量和EMPS显著高于对照组。持续小剂量西地那非治疗后，IIEF-5评分较治疗前明显提高(17.8±6.1 vs 10.5±4.9)、EHGS较治疗前提高明显(3.2±0.5 vs 2.3±0.8)（P＜0.05），外周循环EPCs数量和EMPS明显低于治疗前。结论：持续小剂量口服西地那非能有效改善勃起功能，同时对内皮功能的改善也有一定的作用。%Objective To assess the relationship between endothelial function level and erectile dysfunc⁃tion, indicators of peripheral circulation endothelial progenitor cells(EPCs), endothelial microparticles (EMPs) et al. were detected to compare the changes of endothelial function before and after the long-term treatment of small dose Sildenaf. Methods A total of 60 ED patients and 30 controls were treated with oral Sildenaf at 25 mg/d for 3 months continuously, and evaluated by international index of erectile function-5 (IIEF-5), erectile hardness grading scale (EHGS),and EMPs and EPCs were detected by flow cytometry. Results The IIEF-5 of ED group was significantly lower than that of the control group(10.5±4.9 vs 23.7±1.0), EHGS of ED group was significantly lower than that of the control group(2.3±0.8 vs3.9±0.5) (P<0.05), and the number of peripheral cir⁃culation EPCs and EMPs was significantly higher than that of the control group. After continuous Sildenaf thera⁃py(low dose), the score of IIEF-5 improved significantly(17.8 ± 6.1vs10.5 ± 4.9), EHGS was significantly higher than before (3.2±0.5 vs 2.3±0.8) (P<0.05), and the number of peripheral circulation EPCs and, EMPs were sig⁃nificantly lower than before. Conclusion Continuous oral administration of small doses Sildenaf can effective⁃ly improve erectile function, while playing an important role in improving endothelial function.
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