PDE -5抑制剂对女性的影响:它们有帮助吗?

T. Mostafa
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摘要

简介:口服磷酸二酯酶同酶-5抑制剂(PDE5-Is)的引入通过提供有效的治疗勃起功能障碍,彻底改变了性医学。PDE5水解环GMP特异性为5 ' -GMP。自发射以来,pde5 - i因其对人类福祉的各种潜在影响而激发了科学界的兴趣。目的:强调PDE5-Is对女性可能的潜在影响。参与者和方法:在Medline、医学主题词数据库、Scopus、The Cochrane Library、Embase和CINAHL数据库中检索相关文章,进行系统评价,直至2017年6月,无语言限制。用于评估结果和相关关联的关键词是PDE5抑制剂、西地那非、他达拉非、伐地那非、阿那非、女性和女性。主要结局指标:PDE5-Is对女性的不同影响。结果:口服PDE5-Is对女性有有益的医学意义。性暗示包括女性性功能障碍、女性性唤起障碍、抗抑郁相关性功能障碍和受影响的关系。妇科影响包括子宫内膜增厚、流产、先兆子痫、胎儿生长受限、阴蒂充血、原发性痛经、子宫血流量、羊水过少、卵巢反应差、卵巢缺血/再灌注、子宫收缩。泌尿外科的影响包括膀胱过度活动和间质性膀胱炎,而皮肤病学的影响包括系统性硬化症和脂肪团。此外,pde5已被证明对肺动脉高压、冠状动脉功能障碍、食管运动和一些代谢作用有益。结论:口服PDE5-Is是一种引人注目的治疗类药物,对女性有益,经过精心设计的临床试验,具有潜在的应用前景。
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PDE -5 inhibitors’ implications in women: Are they of help?
Introduction: Introduction of the oral phosphodiesterase isoenzyme-5 inhibitors (PDE5-Is) has revolutionized sexual medicine by affording effective treatment for erectile dysfunction. PDE5 hydrolyses cyclic GMP specifically to 5′-GMP. Since its launching, PDE5-Is have stimulated scientific interest for their impending benefits in various implications for the welfare of the human beings.  Aim: To highlight the possible potential implications of PDE5-Is in women.Participants and methods: A systematic review was carried out till June 2017 based on a search of concerned articles in Medline, medical subject heading databases, Scopus, The Cochrane Library, Embase, and CINAHL databases without language restriction. Keywords used to assess that outcome and concerned associations were PDE5 inhibitors, sildenafil, tadalafil, vardenafil, avanafil, women, and females.Main outcome measures: Different implications for PDE5-Is in women.Results: Oral PDE5-Is have beneficial medical implications in women. Sexual implications include female sexual dysfunction, female sexual arousal disorder, antidepressant-associated sexual dysfunction, and affected relationship. Gynecological implications include endometrial thickness, abortion, preeclampsia, fetal growth restriction, clitoral engorgement, primary dysmenorrhea, uterine blood flow, oligohydramnios, poor ovarian response, ovarian ischemia/reperfusion, and uterine contractility. Urological implications include overactive bladder and interstitial cystitis, whereas dermatological implications include systemic sclerosis and cellulite. In addition, PDE5-Is proved to be beneficial in pulmonary arterial hypertension, coronary dysfunction, esophageal motility, and some metabolic effects.Conclusion: Oral PDE5-Is are an eye-catching therapeutic class of agents with beneficial effects for women, which could be potentially applied after well-designed clinical trials.
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