McNeill S A, Hargreave T B, Geffriaud-Ricouard C, Santoni J, Roehrborn C G
Western General Hospital, Edinburgh, Scotland, United Kingdom
Urology. 2001 Mar;57(3):459-65. doi: 10.1016/s0090-4295(00)01021-9.
A pooled analysis was conducted in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia to examine the relationship between the postvoid residual urine (PVR) volume and various clinical characteristics and to assess the effect of alfuzosin, a clinically uroselective alpha(1)-blocker, on PVR volume and any other associated outcome.
Nine hundred fifty-three patients, 42 to 89 years old, with a baseline PVR volume between 50 and 350 mL (mean 106 mL) were enrolled in 11 double-blind controlled studies and received either alfuzosin (n = 607) or placebo (n = 346) for 1 to 6 months. The relationships between the baseline PVR volume measured by transabdominal ultrasound and age, symptoms, maximum flow rate (Qmax), estimated bladder capacity, and prostate-specific antigen level were assessed. The changes in the PVR volume with treatment were evaluated in all available patients at three endpoints (1, 3, and 6 months).
At baseline, a PVR volume of 100 mL or greater was observed in 60%, 47%, and 39% of patients with a Qmax less than 8, 8 to 11, and greater than 11 mL/s, respectively (P = 0.001). The bladder capacity was also significantly related to the Qmax (P = 0.0001). No relationship was found between PVR volume and age, symptoms, or prostate-specific antigen level. The changes in the PVR volume with treatment were related to the baseline PVR volume. However, at all endpoints and whatever the baseline PVR volume, the decreases in the PVR volume were significantly (P <0.01) greater with alfuzosin than with placebo. Acute urinary retention occurred in 7 patients (2 [0.3%] of 607 patients taking alfuzosin and 5 [1.4%] of 346 patients taking placebo); 6 of these 7 patients had a baseline PVR volume greater than 100 mL.
In this population of men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia, the PVR olume and bladder capacity were related to the baseline Qmax. Alfuzosin significantly reduced the PVR volume compared with placebo, and this effect was more marked in patients with a high PVR volume at baseline. Acute urinary retention occurred mainly in patients with a PVR volume greater than 100 mL and was less frequent in patients taking alfuzosin than in those taking placebo.
对有提示良性前列腺增生的下尿路症状的患者进行一项汇总分析，以研究残余尿量（PVR）与各种临床特征之间的关系，并评估临床应用的尿路选择性α1受体阻滞剂阿夫唑嗪对PVR以及任何其他相关结局的影响。
953例年龄在42至89岁之间、基线PVR在50至350 mL（平均106 mL）的患者纳入11项双盲对照研究，接受阿夫唑嗪（n = 607）或安慰剂（n = 346）治疗1至6个月。评估经腹部超声测量的基线PVR与年龄、症状、最大尿流率（Qmax）、估计膀胱容量和前列腺特异性抗原水平之间的关系。在三个时间点（1、3和6个月）对所有可用患者评估治疗后PVR的变化。
基线时，Qmax小于8、8至11以及大于11 mL/s的患者中，分别有60%、47%和39%的患者PVR量≥100 mL（P = 0.001）。膀胱容量也与Qmax显著相关（P = 0.0001）。未发现PVR量与年龄、症状或前列腺特异性抗原水平之间存在关联。治疗后PVR的变化与基线PVR量有关。然而，在所有时间点以及无论基线PVR量如何，阿夫唑嗪组PVR量的减少均显著大于安慰剂组（P <0.01）。7例患者发生急性尿潴留（服用阿夫唑嗪的607例患者中有2例[0.3%]，服用安慰剂的346例患者中有5例[1.4%]）；这7例患者中有6例基线PVR量大于100 mL。
在这群有提示良性前列腺增生的下尿路症状的男性患者中，PVR量和膀胱容量与基线Qmax有关。与安慰剂相比，阿夫唑嗪显著降低了PVR量，且这种效应在基线PVR量高的患者中更明显。急性尿潴留主要发生在PVR量大于100 mL的患者中，服用阿夫唑嗪的患者比服用安慰剂的患者发生率更低。
