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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 To investigate the effect of different combined antihypertensive regimens on erectile function in hypertensive men. Methods A total of 148 hypertensive patients ≤60 years old were randomly divided into three groups: group A [felodipine 5 mg / d + irbesartan 150 mg / d (n = (F = 49), group B (felodipine 5 mg / d + metoprolol succinate 47.5 mg / d, n = 46) )]. Four weeks of treatment, if the blood pressure was ≥140 / 90 mm Hg, the dose of felodipine doubled. Follow-up in June. The levels of IIEF-5, serum testosterone and sex hormone binding globulin (SHBG) were assessed before and after treatment with International Male Sexual Awareness Index (IIEF-5). Results After treatment, there was no significant difference between the two groups (all P> 0.05). Before and after treatment, the total incidence of erectile dysfunction (ED) was 34.46% and 35.81%, respectively, with no significant difference (P> 0.05). Before and after treatment, the incidence of mild, moderate and severe ED was not statistically different. There was no significant difference in the IIEF-5 scores of the moderate and severe ED before and after treatment in the three groups, but the IIEF-5 score of the patients with mild to moderate ED was improved in the A group. Three groups of serum testosterone and SHBG no significant difference between before and after treatment. Conclusion Felodipine sustained-release tablets combined with irbesartan tablets is beneficial to the improvement of sexual function in patients with mild to moderate hypertension.