在良性前列腺增生后通过尿道进行前列腺手术后治疗过活性膀症状 - 选择哪种药物?
Cheng-Ling Lee1, Hann-Chorng Kuo1
1Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Tzu chi medical journal
|November 30, 2023
概括
索利菲纳和米拉贝格朗有效地治疗前列腺手术后立即过活性膀 (OAB) 症状. 作为β-3激动剂的米拉贝格伦显示出比抗肌类药物索利费纳更好的安全性,副作用较少.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度活跃的膀 (OAB) 症状经常发生在前列腺经尿道切除 (TUR-P) 或前列腺经尿道切割 (TUI-P) 后,用于良性前列腺阻塞 (BPO).
- 抗肌肉癌药物和β-3激动剂对OAB有效,但在前列腺手术后使用它们是谨慎的,因为潜在的不良事件,如增加后空腔残留和尿路感染.
- 在TUR-P/TUI-P后优化OAB治疗可以改善患者的生活质量.
研究的目的:
- 在接受TUR-P或TUI-P的男性中,比较索利菲纳 (抗肌肉素) 和米拉贝格朗 (β-3激动剂) 的安全性和有效性.
- 评估这些药物对OAB症状评分和早期术后期不良事件的影响.
主要方法:
- 这是一项前性随机试验,涉及57名接受TUR-P或TUI-P治疗BPO的男性.
- 参与者被随机分配给每天接受solifenacin 5 mg,mirabegron 50 mg,或没有药物4周后导管移除.
- 术后2周和4周评估了OAB症状 (紧急性严重性得分,OAB症状得分,国际前列腺症状得分) 和不良事件.
主要成果:
- 在2周后,与对照组相比,solifenacin和mirabegron都显著降低了紧急性严重性得分和OAB症状得分.
- 索利菲纳组的两名患者经历了尿液保留.
- 在术后4周,这三组人群中,症状评分和不良事件的差异并不显著.
结论:
- 索利菲纳和米拉贝格朗在缓解 TUR-P 或 TUI-P 后立即出现的 OAB 症状方面表现出相似的疗效.
- 在没有药物治疗的情况下,OAB症状可以在4周内自发消失.
- 在不良事件方面,米拉贝格伦 (β-3激动剂) 与索利费纳辛 (抗肌糖药) 相比,似乎具有更有利的安全概况.
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