应用α受体阻断剂治疗神经源性膀胱排空患者的疗效和安全性.docVIP

PAGE PAGE 2 应用α受体阻断剂治疗神经源性膀胱排空患者的疗效和安全性 李 东，廖利民，胡 洋，鞠彦合，付 光，吴 娟，梁文立 （中国康复研究中心附属北京博爱医院泌尿外科，北京，100068） 摘 要：目的 在神经源性膀胱排空障碍患者中应用α-1肾上腺素能受体阻滞剂阿夫唑嗪，观察其疗效和安全性。方法 对109例神经源性膀胱患者口服阿夫唑嗪药物治疗进行临床观察。服药方法是口服阿夫唑嗪每日1次，每次10mg，睡前服用，共治疗12周。其中同时服用肌松药如巴氯芬和/或地西泮有44例。通过对治疗前后进行影像尿动力学检查获得的平均最大尿道压力（MUP），平均残余尿量（MRUV），平均膀胱颈开放程度（MBNO）—后尿道直径等数据进行分析，评价阿夫唑嗪治疗神经源性膀胱排空障碍的有效性和安全性。结果 服药12周后，109例患者有8例（7%）因头晕、体位性低血压不能耐受退出观察；其余101例患者平均最大尿道压力从（69.20±22.97） cmH2O下降到（57.18±19.41）cmH2O，平均膀胱颈开放程度从（6±5）mm增加到（7.67±4.89）mm、平均残余尿量从（120±30）ml降低到（96±25.5）ml，治疗前后具有统计学差异（P0.01）；单独服药与联合用药2组间数据对比没有统计学差异（P0.05）。结论 口服α-1肾上腺素能受体阻滞剂阿夫唑嗪可以降低神经源性膀胱患者的尿道压力，减少残余尿量，改善排尿。 关键词：α-1肾上腺素能受体阻滞剂；阿夫唑嗪；神经源性膀胱；影像尿动力学检查 中图法分类号： 文献标识码：A Efficacy and safety of α-blocker agent therapy for neurogenic voiding dysfunction LI Dong, LIAO Li-min, HU Yang, JU Yan-he, FU Guang, WU Juan, LIANG Wen-li (Department of Urology, Beijing Charity Hospital, China Rehabilitation Research Center, Beijing 100068, China) Abstract：Objective To investigate the efficacy and safety of alfuzosin, an alpha-1 adrenoceptor antagonist, on the treatment of neurogenic voiding dysfunction. Methods Totally 109 patients with neurogenic bladder were treated by administration of alfuzosin. The delayed release type 10 mg per night for 12 weeks. Of them, 44 were combined with striated muscle relaxants such as baclofen or diazepam. The efficacy were analyzed by comparing the maximal urethral pressure (MUP), mean residual urine volume (MRUV), mean bladder neck openness (MBNO) before and after the drug usage. Results Eight patients (7%) discontinued the trial because of dizziness and postural hypotension, and the other 101 patients completed the trial. MUP was decreased from 69.20±22.97 cmH2O to 57.18±19.41cmH2O, MRUV from 120±30 ml to 96±25.5 ml, and MBNO increased from 6±5 mm to 7.67±4.89 mm. Statistical difference was significant (P0.01). But there was no statistical difference between the alfuzosin group and the combin