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男性下尿路症状患者应用α受体阻滞剂治疗后自主神经系统活动的变化。

Changes in autonomic nervous system activity after treatment with alpha-blocker in men with lower urinary tract symptoms.

机构信息

Department of Urology, Ajou University College of Medicine, Suwon, Korea.

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Investig Clin Urol. 2018 Jan;59(1):49-54. doi: 10.4111/icu.2018.59.1.49. Epub 2017 Dec 15.

Abstract

PURPOSE

To determine changes in autonomic nervous system activity after treatment in men with lower urinary tract symptoms (LUTS), we evaluated changes in patients' symptoms, uroflowmetry, and heart rate variability (HRV) after treatment with alpha-blockers for 12 weeks.

MATERIALS AND METHODS

Ninety-five men who had LUTS (International Prostate Symptom Score [IPSS] ≥8) were included in this study. We divided them into two groups on the basis of a low frequency/high frequency (LF/HF) ratio of 1.6. After treatment with Xatral XL (Handok Inc., Korea) 10 mg for 3 months, we rechecked their IPSS, uroflowmetry, HRV and compared these with the baseline measurements.

RESULTS

Fifty-four men were assigned to the low LF/HF group (group A: LF/HF ≤1.6) and 41 men to the high LF/HF group (group B: LF/HF >1.6). At baseline and 12 weeks, none of the parameters differed significantly between the groups except for HF, which is one of the parameters of HRV. IPSS, the IPSS-voiding subscore, and the IPSS-storage subscore decreased and maximal uroflow increased significantly after 12 weeks of treatment. Whereas the baseline LF/HF ratio increased from 0.89±0.407 to 1.80±1.804 after treatment in group A, it decreased from 3.93±5.471 to 1.79±1.153 in group B.

CONCLUSIONS

The efficacies of Xatral XL were clear in both groups. We found that the LF/HF ratio in the two groups merged to a value of approximately 1.79 after treatment. We suggest that this could be a clue to the importance of balance in autonomic nervous system activity in men with LUTS.

摘要

目的

通过评估男性下尿路症状(LUTS)患者在接受α受体阻滞剂治疗 12 周后症状、尿流率和心率变异性(HRV)的变化,来确定自主神经系统活动的变化。

材料和方法

本研究共纳入 95 例 LUTS 患者(国际前列腺症状评分[IPSS]≥8)。我们根据低频/高频(LF/HF)比值将他们分为两组,比值为 1.6。在服用 Handok Inc.(韩国)生产的 Xatral XL(10mg)治疗 3 个月后,我们重新检查了他们的 IPSS、尿流率,并与基线测量值进行了比较。

结果

54 例患者被分到 LF/HF 比值较低的组(A 组:LF/HF≤1.6),41 例患者分到 LF/HF 比值较高的组(B 组:LF/HF>1.6)。在基线和 12 周时,除 HRV 的一个参数 HF 外,两组之间的所有参数均无显著差异。IPSS、IPSS 排尿分量表和 IPSS 存储分量表在治疗 12 周后均显著下降,最大尿流率显著增加。而在 A 组,治疗后 LF/HF 比值从 0.89±0.407 增加到 1.80±1.804,B 组则从 3.93±5.471 减少到 1.79±1.153。

结论

Xatral XL 在两组中的疗效均明显。我们发现两组的 LF/HF 比值在治疗后均合并为约 1.79。我们认为这可能是男性 LUTS 患者自主神经系统活动平衡重要性的线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f5a/5754583/2b38bb19d814/icu-59-49-g001.jpg

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