Tanuma Yasushi, Tanaka Yoshinori, Takeyama Ko, Okamoto Tomoshi
Department of Urology, Hokkaido Social Welfare Association Hakodate Hospital, Hakodate, Japan.
Department of Urology, Hokkaido Prefectural Esashi Hospital, Esashi, Japan.
Urol Ann. 2016 Jan-Mar;8(1):20-5. doi: 10.4103/0974-7796.157979.
There have been reports that one of the factors affecting the efficacy of α1-adrenoceptor antagonists (α1-blocker; α1-B) was prostate volume (PV). However, there are few reports of short-term prospective trials comparing the efficacy of α1-B by PV. We examined the influence of PV on the short-term efficacy of naftopidil dose increase therapy to administration of 75 mg/day after an initial dose of 50 mg/day.
A total of 85 patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) received 50 mg/day of naftopidil for 4 weeks. After 4 weeks, the dosage of naftopidil was increased to 75 mg/day for a further 4 weeks. We divided the patients into two groups of PV ≥40 mL at baseline (Group L) and PV <40 mL at baseline (Group S).
International Prostate Symptom Score (IPSS), IPSS storage symptoms, and IPSS quality-of-life score were significantly improved at 4 and 8 weeks compared with baseline in both Groups. IPSS voiding symptoms (IPSS-VS) were significantly improved at 4 and 8 weeks compared with baseline in Group S. IPSS and IPSS-VS were significantly improved at 8 weeks compared with 4 weeks only in Group L. IPSS-VS and intermittency at 4 weeks were significantly decreased in Group S compared with Group L. Maximum flow rate was significantly improved at 8 weeks compared with baseline in Group L.
PV is a predictive factor affecting the efficacy of naftopidil 50 mg/day for IPSS-VS, and the dose increase to 75 mg/day effective for IPSS-VS. A total of 50 mg/day of naftopidil is the maintenance dose for LUTS/BPH patients with a small PV, and 75 mg/day of dose increase therapy should be chosen for patients with a large PV.
有报道称，影响α1肾上腺素能受体拮抗剂（α1阻滞剂；α1-B）疗效的因素之一是前列腺体积（PV）。然而，很少有关于按PV比较α1-B疗效的短期前瞻性试验报告。我们研究了PV对萘哌地尔剂量增加疗法（从初始剂量50mg/天增加至75mg/天）短期疗效的影响。
总共85例伴有良性前列腺增生的下尿路症状（LUTS/BPH）患者接受50mg/天的萘哌地尔治疗4周。4周后，萘哌地尔剂量增加至75mg/天，再治疗4周。我们将患者分为两组，基线时PV≥40mL的患者为L组，基线时PV<40mL的患者为S组。
与基线相比，两组患者在4周和8周时国际前列腺症状评分（IPSS）、IPSS储尿期症状评分以及IPSS生活质量评分均显著改善。与基线相比，S组患者在4周和8周时IPSS排尿期症状评分（IPSS-VS）显著改善。仅在L组中，与4周相比，8周时IPSS和IPSS-VS显著改善。与L组相比，S组在4周时IPSS-VS和排尿中断情况显著降低。与基线相比，L组患者在8周时最大尿流率显著改善。
PV是影响50mg/天萘哌地尔对IPSS-VS疗效的预测因素，剂量增加至75mg/天对IPSS-VS有效。对于PV较小的LUTS/BPH患者，50mg/天的萘哌地尔是维持剂量，对于PV较大的患者应选择75mg/天的剂量增加疗法。
