索利那新治疗膀胱过度活动症对逼尿肌功能的影响

目的 评估索利那新治疗膀胱过度活动症(overactive bladder,OAB)患者12周前后逼尿肌功能的变化.方法 2010年3-7月,20例OAB患者服用索利那新治疗.男12例,女8例.年龄21～83岁,平均43岁.病程1～20年,平均8年.患者连续服用索利那新5 mg/d 12周.服药前后行尿动力学检查,观察逼尿肌功能变化、记录OABSS得分、感知膀胱症状量表(PPBC)评分,统计学比较治疗前后的差异.结果 患者治疗前后平均逼尿肌无抑制收缩波个数分别为2.3±2.4与0.6±1.3,差异有统计学意义(P＜0.05);其中6例患者服药后逼尿肌无抑制收缩完全消失.治疗前后膀胱初次排尿感容量(103±67 ml与178±89 ml)、膀胱容量(189±133 ml与299±89 ml)差异有统计学意义(P＜0.01);膀胱顺应性、最大尿流率时逼尿肌压力差异无统计学意义(P＞0.05).服药前后OABSS量表的尿急评分(5.0±0.0与2.8±2.0)、白天排尿评分(1.3±0.5与0.4±0.7)、夜尿评分(2.9±0.4与1.4±0.92)、尿失禁评分(3.3±2.1与1.6±2.1)、PPBC评分(5.5±0.5与2.9±1.6)差异均有统计学意义(P＜0.05).6例患者诉有口干现象.结论 索利那新12周治疗可明显降低OAB患者逼尿肌无抑制收缩,增加逼尿肌储尿量,减少OAB症状,提高生活质量.

Abstract：

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder (OAB).Methods A total of 20 outpatients with OAB of.1 - 20 ( mean, 8 )years, 12 males and 8 females, aged 21 - 83 ( mean, 43) years were included in this study.Five mg solifenacin was given orally once daily for 12 weeks.Before and after treatment, overactive bladder symptom score (OABSS), patient perception of bladder condition symptoms rating scale (PPBC), and filling cystometry was performed.Results Before and after solifenacin administration, significant decrease were detected in term of unstable detrusor waves ( 2.3 ± 2.4) vs (0.6 ± 1.3 ) ( P ＜ 0.05 ), and detrusor overactivity ( DO ) disappeared in 6 patients.Bladder capacities at first desire to void and maximum bladder capacity were significantly increased (P ＜0.01 ).Bladder compliance and detrusor pressure at maximum urine flow had no significant difference (P ＞ 0.05 ).All patients had significant improvement in OAB symptoms evaluating by OABSS and PPBC ( P ＜ 0.05 ).Six patients had mild side effect of dry mouth and could be relieved by drinking more water.Conclusion Urodynamically, solifenacin decreases the detrusor overactivity, increases the bladder capacity and improves the quality of life of OAB patients.

Effects of solifenacin on overactive bladder patients

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder (OAB).Methods A total of 20 outpatients with OAB of.1 - 20 ( mean, 8 )years, 12 males and 8 females, aged 21 - 83 ( mean, 43) years were included in this study.Five mg solifenacin was given orally once daily for 12 weeks.Before and after treatment, overactive bladder symptom score (OABSS), patient perception of bladder condition symptoms rating scale (PPBC), and filling cystometry was performed.Results Before and after solifenacin administration, significant decrease were detected in term of unstable detrusor waves ( 2.3 ± 2.4) vs (0.6 ± 1.3 ) ( P ＜ 0.05 ), and detrusor overactivity ( DO ) disappeared in 6 patients.Bladder capacities at first desire to void and maximum bladder capacity were significantly increased (P ＜0.01 ).Bladder compliance and detrusor pressure at maximum urine flow had no significant difference (P ＞ 0.05 ).All patients had significant improvement in OAB symptoms evaluating by OABSS and PPBC ( P ＜ 0.05 ).Six patients had mild side effect of dry mouth and could be relieved by drinking more water.Conclusion Urodynamically, solifenacin decreases the detrusor overactivity, increases the bladder capacity and improves the quality of life of OAB patients.