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在治疗不耐药的神经性下尿路功能障碍的儿科患者中,mirabegron的长期有益作用
Felice E E van Veen1, Martje Schotman1, Lisette A 't Hoen1
1Department of Urology and Pediatric Urology, Sophia Children's Hospital, Erasmus MC, Rotterdam, the Netherlands.
Journal of pediatric urology
|September 1, 2023
概括
米拉贝格朗有效治疗其他治疗不耐药的儿童的神经性下尿路功能障碍 (NLUTD). 它改善了膀的服从性,并减少了失禁,特别是当作为附加疗法使用时.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 儿童的神经性下尿路功能障碍 (NLUTD) 可能导致严重的并发症,如功能衰竭和尿失禁.
- 已建立的治疗方法,如抗肌肉毒药 (AM) 和肉毒素注射 (BoNT-A),对所有患者都不有效,导致不耐药病例.
研究的目的:
- 评估米拉贝格朗在患有NLUTD且对标准治疗不耐药的儿科患者的疗效和长期结果.
- 评估mirabegron作为耐火NLUTD的独立和附加疗法.
主要方法:
- 在34名儿科患者 (18岁以下) 的回顾性研究中,NLUTD对AM和/或BoNT-A耐药,接受了mirabegron (50毫克) 治疗.
- 米拉贝格朗作为单一疗法或作为现有治疗 (AM/BoNT-A) 的辅助剂,并与干净间歇性导管 (CIC) 一起使用.
- 视频尿动力学研究 (VUDSs) 在治疗前和治疗后进行,以评估膀顺应性,容量,detrusor过度活性的变化以及膀外流的变化.
主要成果:
- 膀遵守的显著改善 (89.9%的增加,p<0.001),最大的囊泡计容量,并降低了末端填充的排泄器压力.
- 检测到的显著改善在体过度活跃,膀外流和尿失禁方面.
- 与单一治疗相比,Mirabegron补充疗法显示出优异的视频-尿动力学改善;没有患者报告的副作用.
结论:
- 米拉贝格朗是治疗不耐药的儿童的有价值和有效的治疗选择,为大约两年提供持续的益处.
- 这项研究证实了米拉贝格朗的有益作用,特别是作为儿科患者的附加疗法.
- 虽然有效,但大约两年后可能需要额外的治疗方法,这突显了NLUTD管理的慢性性质.
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