PDF(Pubmed)
Abstract：
UNASSIGNED: Erectile dysfunction (ED) is common in patients with compensated cirrhosis but its impact on the quality of life (QOL) is usually overlooked. This study aimed at determining the frequency of ED in male patients with compensated chronic liver disease (CLD), assessing their QOL and the response to treatment with tadalafil. A secondary aim was to assess the effect of the tadalafil therapy on liver fibrosis, if any.
UNASSIGNED: Consecutive patients with compensated CLD and advanced liver fibrosis were screened at the baseline with the International Index of Erectile Function-5 (IIEF-5), QOL questionnaire (WHOQOL-BREF), liver stiffness measurements (LSM) made with Fibroscan™ (Echosens, France), and fibrosis index based on 4 factors (FIB-4) scores. Patients with ED meeting eligibility criteria were prescribed PDE5 inhibitor tadalafil 20 mg on alternate days. During the follow-up, IIEF-5, LSM, and FIB-4 were monitored after 3 and 6 months while the WHOQOL-BREF questionnaire was administered at the baseline and at 6 months.
UNASSIGNED: Among 89 patients with CLD and advanced liver fibrosis, ED was present in 43 (48%) and tadalafil was prescribed to 34 patients (38%) meeting exclusion and inclusion criteria. At 3 months follow-up, the mean IIEF 5 score increased from 15.57 ± 4 to 20.78 ± 3.6, (P = 0.0001) and the improvement persisted at 6 months (IIEF-5 score 21.87 ± 2.2; P = 0.12). The physical, social relationships, and environment domains in the WHOQOL-BREF questionnaire showed significant improvement at six months (P < 0.05) but not the psychological domain (P = ns). From a baseline value of 12.69 ± 3.1 kPa, the mean LSM decreased to 11.37 ± 3.9 kPa, (P = 0.02) after 3 months on tadalafil. After 6 months, the LSM further decreased from 11 ± 0.9 to 8.2 ± 3.2 kPa (P = 0.034). FIB-4 values showed a decline from the baseline at 3 months, from 1.52 ± 0.58 to 1.32 ± 0.55, P < 0.05 and at 6 months, from 1.25 ± 0.53 to 0.97 ± 0.36, P > 0.05. The CAP values did not show any significant change. There was an insignificant decline in the SGOT and SGPT levels (P > 0.05) with no significant change in CTP or MELD scores.
UNASSIGNED: In the short term, tadalafil improves ED and QOL in patients with CLD and advanced liver fibrosis. It may also reduce liver fibrosis in them. Further studies that include liver histology are needed to confirm this preliminary observation of a possible antifibrotic effect.
UNASSIGNED: Consecutive patients with compensated CLD and advanced liver fibrosis were screened at the baseline with the International Index of Erectile Function-5 (IIEF-5), QOL questionnaire (WHOQOL-BREF), liver stiffness measurements (LSM) made with Fibroscan™ (Echosens, France), and fibrosis index based on 4 factors (FIB-4) scores. Patients with ED meeting eligibility criteria were prescribed PDE5 inhibitor tadalafil 20 mg on alternate days. During the follow-up, IIEF-5, LSM, and FIB-4 were monitored after 3 and 6 months while the WHOQOL-BREF questionnaire was administered at the baseline and at 6 months.
UNASSIGNED: Among 89 patients with CLD and advanced liver fibrosis, ED was present in 43 (48%) and tadalafil was prescribed to 34 patients (38%) meeting exclusion and inclusion criteria. At 3 months follow-up, the mean IIEF 5 score increased from 15.57 ± 4 to 20.78 ± 3.6, (P = 0.0001) and the improvement persisted at 6 months (IIEF-5 score 21.87 ± 2.2; P = 0.12). The physical, social relationships, and environment domains in the WHOQOL-BREF questionnaire showed significant improvement at six months (P < 0.05) but not the psychological domain (P = ns). From a baseline value of 12.69 ± 3.1 kPa, the mean LSM decreased to 11.37 ± 3.9 kPa, (P = 0.02) after 3 months on tadalafil. After 6 months, the LSM further decreased from 11 ± 0.9 to 8.2 ± 3.2 kPa (P = 0.034). FIB-4 values showed a decline from the baseline at 3 months, from 1.52 ± 0.58 to 1.32 ± 0.55, P < 0.05 and at 6 months, from 1.25 ± 0.53 to 0.97 ± 0.36, P > 0.05. The CAP values did not show any significant change. There was an insignificant decline in the SGOT and SGPT levels (P > 0.05) with no significant change in CTP or MELD scores.
UNASSIGNED: In the short term, tadalafil improves ED and QOL in patients with CLD and advanced liver fibrosis. It may also reduce liver fibrosis in them. Further studies that include liver histology are needed to confirm this preliminary observation of a possible antifibrotic effect.
摘要：
■勃起功能障碍（ED）在代偿性肝硬化患者中很常见，但其对生活质量（QOL）的影响通常被忽视。这项研究旨在确定男性患者的ED频率代偿性慢性肝病（CLD），评估他们的生活质量和对他达拉非治疗的反应。次要目的是评估他达拉非治疗对肝纤维化的影响，如果有的话。
■使用国际勃起功能指数-5（IIEF-5）在基线时对代偿性CLD和晚期肝纤维化的连续患者进行筛查，QOL问卷（WHOQOL-BREF），使用Fibroscan™（Echosens，法国),和基于4个因素（FIB-4）评分的纤维化指数。符合资格标准的ED患者隔日服用PDE5抑制剂他达拉非20mg。在后续行动中,IIEF-5LSM,和FIB-4在3个月和6个月后进行监测,而WHOQOL-BREF问卷在基线和6个月时进行.
■在89例CLD和晚期肝纤维化患者中，43例（48％）出现ED，34例（38％）符合排除和纳入标准的患者服用他达拉非。随访3个月时,平均IIEF-5评分从15.57±4增加至20.78±3.6(P=0.0001),且在6个月时持续改善(IIEF-5评分21.87±2.2;P=0.12).物理，社会关系,WHOQOL-BREF问卷中的环境领域在六个月时显示出显着改善（P<0.05），而心理领域则没有改善（P=ns）。基线值为12.69±3.1kPa,平均LSM降至11.37±3.9kPa，使用他达拉非3个月后（P=0.02）。六个月后,LSM从11±0.9下降到8.2±3.2kPa(P=0.034)。FIB-4值显示在3个月时从基线下降，从1.52±0.58到1.32±0.55，P<0.05，6个月时，从1.25±0.53到0.97±0.36，P>0.05。CAP值未显示任何显著变化。SGOT和SGPT水平无明显下降（P>0.05），CTP或MELD评分无明显变化。
■在短期内，他达拉非改善CLD和晚期肝纤维化患者的ED和QOL。它还可以减少他们的肝纤维化。需要进一步的研究，包括肝组织学，以证实可能的抗纤维化作用的初步观察。
■使用国际勃起功能指数-5（IIEF-5）在基线时对代偿性CLD和晚期肝纤维化的连续患者进行筛查，QOL问卷（WHOQOL-BREF），使用Fibroscan™（Echosens，法国),和基于4个因素（FIB-4）评分的纤维化指数。符合资格标准的ED患者隔日服用PDE5抑制剂他达拉非20mg。在后续行动中,IIEF-5LSM,和FIB-4在3个月和6个月后进行监测,而WHOQOL-BREF问卷在基线和6个月时进行.
■在89例CLD和晚期肝纤维化患者中，43例（48％）出现ED，34例（38％）符合排除和纳入标准的患者服用他达拉非。随访3个月时,平均IIEF-5评分从15.57±4增加至20.78±3.6(P=0.0001),且在6个月时持续改善(IIEF-5评分21.87±2.2;P=0.12).物理，社会关系,WHOQOL-BREF问卷中的环境领域在六个月时显示出显着改善（P<0.05），而心理领域则没有改善（P=ns）。基线值为12.69±3.1kPa,平均LSM降至11.37±3.9kPa，使用他达拉非3个月后（P=0.02）。六个月后,LSM从11±0.9下降到8.2±3.2kPa(P=0.034)。FIB-4值显示在3个月时从基线下降，从1.52±0.58到1.32±0.55，P<0.05，6个月时，从1.25±0.53到0.97±0.36，P>0.05。CAP值未显示任何显著变化。SGOT和SGPT水平无明显下降（P>0.05），CTP或MELD评分无明显变化。
■在短期内，他达拉非改善CLD和晚期肝纤维化患者的ED和QOL。它还可以减少他们的肝纤维化。需要进一步的研究，包括肝组织学，以证实可能的抗纤维化作用的初步观察。
