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萘哌地尔治疗良性前列腺增生所致排尿困难的有效性及其最佳剂量——75毫克与50毫克的比较

Usefulness of naftopidil for dysuria in benign prostatic hyperplasia and its optimal dose--comparison between 75 and 50 mg.

作者信息

Oh-oka Hitoshi

机构信息

Department of Urology, Kobe Medical Center, Kobe, Japan.

出版信息

Urol Int. 2009;82(2):136-42. doi: 10.1159/000200787. Epub 2009 Mar 19.

Abstract

BACKGROUND/OBJECTIVES: The clinical usefulness and optimal dose of naftopidil were evaluated and discussed in 100 patients with benign prostatic hyperplasia without urinary retention.

METHODS

Naftopidil was administered once in the morning in a dose of 75 mg for 6 weeks; following washout for 1 week, a reduced dose of 50 mg was administered for another 6 weeks. Subjective and objective symptoms were clinically evaluated.

RESULTS

Significant improvements were observed in nocturia, IPSS, QOL index, Qmax, Qave, and % postvoid residual urine volume after administration of 75 mg as well as 50 mg. Comparison of the results obtained after administration of 75 and 50 mg revealed improvement only in bladder compliance. Among the items of the IPSS, 'nocturia', 'less than two hours urination', 'weak urinary stream' and 'sensation of not emptying bladder' improved, after administration of 75 as well as 50 mg. The bladder compliance aggravated to 13.6, from 22.1 ml/cm H(2)O after administration of 50 mg.

CONCLUSIONS

Naftopidil could have superior effects in benign prostatic hyperplasia patients whose complaints are storage and voiding symptoms, especially nocturia of three times or more, as well as in patients with low compliance bladder and detrusor overactivity. The recommended dose seems to be 50 mg.

摘要

背景/目的:对100例无尿潴留的良性前列腺增生患者评估并讨论萘哌地尔的临床效用及最佳剂量。

方法

萘哌地尔于早晨单次给药,75毫克剂量服用6周;停药1周后,给予50毫克的减量剂量再服用6周。对主观和客观症状进行临床评估。

结果

服用75毫克及50毫克剂量后,夜尿、国际前列腺症状评分(IPSS)、生活质量指数、最大尿流率(Qmax)、平均尿流率(Qave)及排尿后残余尿量百分比均有显著改善。比较服用75毫克和50毫克剂量后的结果发现,仅膀胱顺应性有所改善。在IPSS项目中,“夜尿”“排尿时间少于两小时”“尿流无力”及“膀胱未排空感”在服用75毫克及50毫克剂量后均有改善。服用50毫克后,膀胱顺应性从22.1毫升/厘米水柱恶化至13.6。

结论

萘哌地尔对以储尿和排尿症状为主要诉求的良性前列腺增生患者可能具有较好疗效,尤其是夜尿三次及以上的患者,以及膀胱顺应性低和逼尿肌过度活动的患者。推荐剂量似乎为50毫克。

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