Hsiao Sheng-Mou, Lin Ho-Hsiung, Kuo Hann-Chorng
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
Neurourol Urodyn. 2014 Mar;33(3):331-4. doi: 10.1002/nau.22394. Epub 2013 Mar 12.
To analyze the predictors of therapeutic success after solifenacin treatment.
Between January 2008 and December 2011, all patients with overactive bladder syndrome (OAB) who consecutively visited the urologic outpatient clinics of a medical center were prospectively enrolled. All enrolled patients received 5 mg solifenacin once a day for 12 weeks.
Overall, 648 patients, 332 men, and 316 women, completed the 12-week study. The overall success rate was 48.8%. The success rate for female patients was superior to that for male patients (55.4% vs. 42.5%, P < .001). The urgency severity scale (USS) score, daytime frequency, nocturia, voided volume, and bladder capacity were all improved after 12 weeks' treatment. Multivariate logistic regression analysis revealed that female gender, high USS score, high maximum flow rate (Qmax ), and low postvoid residual volume (PVR) were all significant predictive factors for success after antimuscarinic treatment. USS score = 4 and Qmax ≥ 12 ml/sec were the most strongly predictive cutoff values for success, with receiver operating characteristic curve (ROC) areas of 0.70 (sensitivity = 66.8%, specificity = 66.0%) and 0.63 (sensitivity = 80.7%, specificity = 43.1%), respectively. PVR ≥ 70 ml was the most predictive cutoff value for failure, with a ROC area of 0.58 (sensitivity = 18.2%, specificity = 93.7%).
Female gender, high USS score, high Qmax , and low PVR were associated with better therapeutic efficacy. These findings could serve as an initial guide or assist in consultation regarding the treatment of OAB patients with antimuscarinics.
分析索利那新治疗后治疗成功的预测因素。
在2008年1月至2011年12月期间，前瞻性纳入了所有连续就诊于某医疗中心泌尿外科门诊的膀胱过度活动症（OAB）患者。所有纳入患者每天接受5 mg索利那新治疗，持续12周。
总体而言，648例患者（332例男性和316例女性）完成了为期12周的研究。总体成功率为48.8%。女性患者的成功率高于男性患者（55.4%对42.5%，P < 0.001）。经过12周治疗后，尿急严重程度量表（USS）评分、日间排尿频率、夜尿、排尿量和膀胱容量均有所改善。多因素逻辑回归分析显示，女性、USS评分高、最大尿流率（Qmax）高和残余尿量（PVR）低均是抗毒蕈碱治疗成功的显著预测因素。USS评分 = 4且Qmax≥12 ml/秒是成功的最强预测临界值，受试者工作特征曲线（ROC）面积分别为0.70（灵敏度 = 66.8%，特异度 = 66.0%）和0.63（灵敏度 = 80.7%，特异度 = 43.1%）。PVR≥70 ml是失败的最具预测性的临界值，ROC面积为0.58（灵敏度 = 18.2%，特异度 = 93.7%）。
女性、USS评分高、Qmax高和PVR低与更好的治疗效果相关。这些发现可作为初步指导或有助于关于使用抗毒蕈碱药物治疗OAB患者的咨询。
