与中枢神经系统相关的过度活性膀药物的长期临床疗效和认知影响
Yu Khun Lee1, Hann-Chorng Kuo2
1Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Section 3, Chung Yang Road, 707, Hualien, Taiwan.
International urology and nephrology
|September 23, 2025
概括
与中枢神经系统 (CNS) 相关的过度活性膀 (OAB) 药物显示出类似的疗效,但耐受性不同. 认知障碍显著影响了治疗结果,需要个性化策略来改善生活质量.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 中枢神经系统 (CNS) 疾病,如脑血管疾病 (CVA),痴呆症和帕金森病 (PD) 经常导致过度活动的膀 (OAB).
- 由于潜在的认知和身体并发症,在这些患者中管理OAB存在独特的挑战.
- 在中枢神经系统受影响的人群中,OAB药物的疗效和认知影响的长期数据有限.
研究的目的:
- 评估用于治疗中枢神经系统相关的OAB的药物的长期临床疗效和认知影响.
- 为了比较不同中枢神经系统疾病 (CVA,痴呆症,PD) 和药物类型的治疗结果.
主要方法:
- 对170名患有CVA,痴呆症或PD的患者进行了回顾性队列研究,这些患者接受了OAB治疗.
- 使用过度活性膀症状评分 (OABSS) 和紧急性严重性评分 (USS) 评估尿路症状.
- 在基线和12,24,36个月使用迷你精神状态检查 (MMSE) 评估认知功能.
主要成果:
- 与CVA (40%) 相比,痴呆症 (69.8%) 和PD (62.5%) 组的药物停用率更高.
- 索利费纳的戒断率最高 (77.8%),而托尔特罗丁的戒断率最低 (36.4%).
- 严重的认知障碍与更高的停药,较差的症状改善和更大的认知衰退有关.
结论:
- 在不同类型中,OAB药物的疗效是可比的,但耐受性有所不同,痴呆症,PD和solifenacin显示更高的断药率.
- 认知障碍显著影响中枢神经系统相关的OAB治疗结果.
- 量身定制的治疗策略和定期的认知评估对于优化治疗有效性和生活质量至关重要.
相关概念视频
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
560
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
560
Alzheimer's Disease: Treatment
825
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
825
Drugs for Treatment of Diarrhea-Predominant IBS
635
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
635
Drugs for Treatment of Constipation-Predominant IBS
726
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
726
Indirect-Acting Cholinergic Agonists: Pharmacological Actions
1.5K
Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
1.5K
Cholinergic Antagonists: Therapeutic Uses
1.4K
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
1.4K


