Department of Urology, Jinling Hospital, Zhongshan East Road 305, Nanjing, Jiangsu, 210002, China.
World J Urol. 2011 Dec;29(6):767-71. doi: 10.1007/s00345-011-0739-3. Epub 2011 Aug 4.
To compare the efficacy of α(1)D-receptor antagonist Naftopidil and α(1)A/D-receptor antagonist Tamsulosin in management of distal ureteral stones.
A total of 131 patients with distal ureteral stones were included in the study from December 2008 to September 2010. The patients were randomized to 3 groups: group 1 (43 patients), those receiving 10 mg naftopidil once daily; group 2 (45 patients), those receiving 0.4 mg tamsulosin once daily; and group 3 (43 patients) were given a watchful waiting and served as control group. All patients were followed up for 2 weeks. Ultrasonography and kidney-ureters-bladder (KUB) were performed on day 7 and 14. At the end of the follow-up period, patients who failed to expel the stone were scheduled to undergo ESWL or ureteroscopy.
Stone expulsion was observed in 31 patients in group 1 (72.1%), 37 patients in group 2 (82.2%), and 13 patients in group 3 (30.2%). A statistically significant difference was noted with Chi-square testing between groups 1 and 3, and groups 2 and 3 (P = 0.000 and P = 0.000, respectively). Average time to expulsion was 7.6 ± 2.26 days (range 1-12 days) in group 1, 7.7 ± 1.94 days (range 2-11 days) in group 2, and 9.4 ± 2.48 days (range 6-14 days) in group 3. A statistically significant difference was observed in time to expulsion between groups 1 and 3, and groups 2 and 3 (P = 0.000, P = 0.001, respectively) by ANOVA testing. The side effects encountered in the study groups were generally mild and did not require cessation of therapy in any patient.
Naftopidil could significantly increase spontaneous passage of distal ureteral stones with low side effects. The stone expulsion rate is similar for the tamsulosin.
比较α（1）D-受体拮抗剂奈哌地尔和α（1）A/D-受体拮抗剂坦索罗辛在治疗输尿管下段结石中的疗效。
2008 年 12 月至 2010 年 9 月，共有 131 例输尿管下段结石患者入组。患者随机分为 3 组：第 1 组（43 例），每天服用 10mg 奈哌地尔；第 2 组（45 例），每天服用 0.4mg 坦索罗辛；第 3 组（43 例）为对照组，采用观察等待法。所有患者均随访 2 周。分别在第 7 天和第 14 天进行超声和肾脏-输尿管-膀胱（KUB）检查。随访结束时，未能排出结石的患者被安排接受 ESWL 或输尿管镜检查。
第 1 组 31 例（72.1%）、第 2 组 37 例（82.2%）和第 3 组 13 例（30.2%）结石排出。卡方检验显示第 1 组与第 3 组和第 2 组与第 3 组之间差异有统计学意义（P = 0.000 和 P = 0.000）。第 1 组平均排石时间为 7.6±2.26 天（1-12 天），第 2 组为 7.7±1.94 天（2-11 天），第 3 组为 9.4±2.48 天（6-14 天）。方差分析显示，第 1 组与第 3 组和第 2 组与第 3 组之间排石时间差异有统计学意义（P = 0.000、P = 0.001）。研究组的不良反应一般较轻，无需停止治疗。
奈哌地尔能显著增加输尿管下段结石的自然排出率，且不良反应低。坦索罗辛的排石率也相似。
