舍尼亭联合α受体阻滞剂对逼尿肌过度活动患者尿动力学的影响
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[摘要] 目的 探讨舍尼亭联合α受体阻滞剂治疗良性前列腺增生伴逼尿肌过度活动尿动力学的影响及疗效。 方法 108例良性前列腺增生伴逼尿肌过度活动患者随机分为观察组和对照组，各54例，分别给予舍尼亭联合可多华和可多华单用治疗。 结果 治疗前两组Qmax、Pdet、VV、PVR、24 h排尿次数之间差异无统计学意义（P > 0.05），治疗后两组Pdet、PVR、24 h排尿次数均较治疗前显著降低，VV则显著升高（P均0.05），两组各指标之间差异有统计学意义（P < 0.05）。治疗后均显著下降，观察组均显著低于对照组（P < 0.05），观察组6例（11.11%）、对照组5例（9.26%）出现轻度不良反应，两组差异无统计学意义。 结论 舍尼亭联合α受体阻滞剂能有效改善尿动力学，缓解良性前列腺增生患者的逼尿肌过度活动，安全有效。
[关键词] 良性前列腺增生；逼尿肌过度活动；舍尼亭；α受体阻滞剂
[中图分类号] R695 [文献标识码] B [文章编号] 1673—9701（2012）26—0056—02
Effect of Tolterodine combined with α—blocker for urodynamic in patients of detrusor overactivity
SHEN Dong
Surgical Department， the Traditional Chinese Medicine Hospital of Xiaoshan in Hangzhou City， Hangzhou 311201， China
[Abstract] Objective To investigate the effect of Tolterodine combined with α—blocker for urodynamic of benign prostatic hyperplasia associated with detrusor overactivity in patients. Methods All of 108 cases of benign prostatic hyperplasia associated with detrusor overactivity were randomly divided into observation group and control group （n = 54），and were given round tolterodine combined with α—blocker and α—blocker alone treatment. Results No significant difference of Pdet，VV and PVR，24 h urination between the Qmax two groups before treatment （P > 0.05）.After treatment，Pdet，PVR，24 h urination of the two groups were significantly reduced，while the VV were significantly increased（P < 0.05）， Qmax before and after treatment difference were not statistically significant（P > 0.05），indicators the difference between two groups were statistically significant（P < 0.05）. The indicators of observation group were significantly lower than the control group （P < 0.05）. Six cases（11.11%）of observation group，5 cases （9.26%）of control group had mild adverse reactions，the difference were not statistically significant. Conclusion Tolterodine combined with α—blocker could effectively improve the urodynamic alleviate benign prostatic hyperplasia in patients with detrusor overactivity.
[Key words] Benign prostatic hyperplasia；Detrusor overactivity；Tolterodine；α—blocker
良性前列腺增生（benign prostatic hyperplasia，BPH）是中老年男性常见生殖器良性病变，常伴逼尿肌过度活动（detrusor overactivity，DO）而导致膀胱出口梗阻引起出现下尿路症状，出现非炎症性的尿频、尿急等症状。α受体阻滞剂能有效缓解前列腺增生导致的膀胱出口梗阻症状，但对逼尿肌过度活动的改善作用欠佳[1]。舍尼亭是一种M胆碱受体阻滞剂，动物实验证明其对膀胱有高度的选择性，用于膀胱过度活动导致的下尿道症状的治疗。本研究探讨舍尼亭联合α受体阻滞剂治疗BPH伴DO的疗效和安全性，现报道如下。
1 资料与方法
1.1 一般资料
选择2010年4月～2012年1月我院收治的BPH合并DO的患者108例，年龄64～82岁，平均（70.37±5.33）岁，病程6个月～19年，排除神经系统、内分泌系统及其他疾病导致的BOO；下尿路结石、前列腺癌、尿道狭窄、压力性尿失禁、泌尿系感染；逼尿肌收缩力（Pdet） 0.05），具有可比性。见表1。