简介：Aim:Toevaluatetheefficacyandsafetyoftransurethralapplicationofalprostadil(MUSE.)forthetreatmentoferectiledysfunctioninIndonesians.Methods:Twentyerectiledysfunctionpatientsagedbetween32-74yearsoldwererecruitedinthisstudy.Theinclusioncriteriawereasfollows:1)adultmales18yearsorolderwithasubjectivecomplaintorerectiledysfunction,2)toprovidewritteninformedconsent,3)toagreenottouseotherformsoftreatmentforerectiledysfunction,4)fulfillthescreeninglaboratoryvalues.Part1,eligiblepatientsweretitratedintheclinicstartingwithadoseof250μgandproceedinastepwisemannerto500μgand1000μgonseparateclinicvisitsuntiltheyidentifiedadosethatproducedasatisfactoryresponse.Theintervalbetweeneachin-clinictitrationwas2-3days.Eachin-clinictitrationdosewasevaluatedat15minintervalsoveraonehourperiodforerectionassessment,bloodpressureandpulse.Part2,patientsusedMUSEathomeforthreemonthsatthedoseidentifiedduringtheinclinictitration.Monthlyinterimvisitswererequiredforpatientfollow-upanddrugdistribution.Attheendofthestudy,patientshadanotherlaboratory(excepttestosterone,onlyassayedinscreeningprocedure)andphysicalexamination.Results:Theetiologyoferectiledysfunctionwaspsychologicalin5patientsandorganicin15patients.The65%ofthepatientsachievedtheerectionscaleof4or5eitherintheclinicorathome,10%achievedthescaleof4athome,butnotintheclinic,and25%onlyachievedthescaleof2or3withthehighestdoseof1000μgeitherintheclinicorathome.Nosignificantdifferenceswerefoundinbiochemicalexaminationbeforeandafterthestudy.The60%ofthepatientswhoachievederectionscale4or5continuedtouseMUSEuntiltheendofthestudy,while40%ofthemcomplainedofpainatthetimeofMUSEapplication,duringerectionand/orduringintercourse.Theywithdrewfromthestudy.Conclusion:Transurethral

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简介：BackgroundPatientswithunstableanginapectorisanddiabetesmellitusareverycommon.Whentheyreceiveinterventionaltherapy,contrastagentscancauserenalinjuryandplateletactivation.Alprostadilhasbeenshowntodecreaseinflammationandmicrovascularresistance.Thereisnoanyreportontheprotectioneffectsofalprostadilonrenalinjuryandtheplateletactivationduringcardiacinterventionaltherapy.MethodsAtotalof57patientsweredividedintotwogroups,alprostadilgroup(n=35)andnormalgroupn=22).BUN(bloodureanitrogen)andSCr(serumcreatine)weremeasuredastherenalfunctionparameters.GFR(glomerularfiltrationrate)wascalculatedbytheMDRDformula.Plateletparameters:PLT(plateletcount,109),PDW(plateletdistributionwidth,fL),MPV(meanplateletvolume,fL),PLCR(largeplateletscaleratio,%)weremeasuredastheplateletactivationindex.TtestandChi-squaretestwereusedasstatisticalmethods,andP<0.05wasconsideredstatisticallysignificant.ResultsInthealprostadilgroup,SCrwas71.1±13.8μmol/Land65.9±12.6μmol/L,beforeandafterinterventionaltherapy(P<0.05).BUNwas5.68±1.79mmol/Land3.86±1.19mmol/L(P<0.001),beforeandafterinterventionaltherapy.Intheplatelettests,MPVwasseemedtobetheonlyusefulplateletparameter,beforeandafterinterventionaltherapy(11.8±1.8fLand11.1±1.2fL,P<0.05),whilethePLT(109/L),PDW(fl),PLCR(%)didn'tshowanysignificantdifference.Inthenormalgroup,allthesetests'resultsdidn'tsignificantlychangeafterinterventionaltherapy.ConclusionsThepatientswiththeunstableanginapectorisanddiabetesmellitushaveontheriskofrenalfunctiondamageandplateletactivationwhenundertakingcardiacinterventionaltherapy.Alprostadilprotectsrenalfunctionandalleviatesplateletactivation.