Lee Cheng-Ling, Kuo Hann-Chorng
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Low Urin Tract Symptoms. 2019 Apr;11(2):O93-O97. doi: 10.1111/luts.12224. Epub 2018 Apr 26.
We examined the efficacy and safety of mirabegron in elderly patients with urodynamic detrusor hyperactivity with impaired contractility (DHIC).
Patients diagnosed with DHIC received daily dose of mirabegron (25mg). Subjective symptom scores, uroflowmetry data, and adverse events (AEs) were recorded for all patients at baseline and after 1, 3, and 6 months treatment. Comparisons were made for each patient individually and between patients with detrusor overactivity (DO).
Of the 65 patients enrolled in the study, 25 had DHIC and 40 had DO (mean [± SD] age 79.3 ± 9.6 and 75.6 ± 10.7 years, respectively). At the 6-month follow-up, significant (P < .05) improvement was seen compared with baseline in both the DHIC and DO groups in terms of OAB symptom scores (4.72 ± 3.05 vs. 6.88 ± 4.06 and 4.50 ± 2.99 vs. 6.70 ± 3.60, respectively), urgency severity score (1.90 ± 2.00 vs. 3.35 ± 1.13 and 1.58 ± 1.93 vs. 3.00 ± 1.65, respectively), and global response assessment (1.80 ± 1.41 and 1.73 ± 1.34, respectively). In the DHIC group, post-void residual (PVR) volume decreased from 153 ± 52.7 mL at baseline to 85.8 ± 90.1 mL at 6th month (P < .05) and voiding efficiency improved from 40.0 ± 20.7% to 62.6 ± 28.3% (P < .05). Common AEs included dry mouth and dizziness, yet 16% of DHIC patients developed PVR >180 mL.
Mirabegron was an effective treatment option in elderly patients with urodynamic DO and DHIC in the present study. The AEs reported were mild and infrequent.
我们研究了米拉贝隆对患有尿动力学逼尿肌活动亢进伴收缩功能受损（DHIC）的老年患者的疗效和安全性。
被诊断为DHIC的患者每日服用米拉贝隆（25毫克）。在基线以及治疗1、3和6个月后，记录所有患者的主观症状评分、尿流率数据和不良事件（AE）。对每位患者个体以及逼尿肌过度活动（DO）患者之间进行比较。
该研究纳入的65例患者中，25例患有DHIC，40例患有DO（平均[±标准差]年龄分别为79.3±9.6岁和75.6±10.7岁）。在6个月的随访中，与基线相比，DHIC组和DO组在膀胱过度活动症（OAB）症状评分方面（分别为4.72±3.05对6.88±4.06以及4.50±2.99对6.70±3.60）、尿急严重程度评分方面（分别为1.90±2.00对3.35±1.13以及1.58±1.93对3.00±1.65）以及整体反应评估方面（分别为1.80±1.41和1.73±1.34）均有显著（P<0.05）改善。在DHIC组中，排尿后残余尿量（PVR）从基线时的153±52.7毫升降至第6个月时的85.8±90.1毫升（P<0.05），排尿效率从40.0±20.7%提高至62.6±28.3%（P<0.05）。常见的不良事件包括口干和头晕，然而16%的DHIC患者出现PVR>180毫升。
在本研究中，米拉贝隆是治疗患有尿动力学DO和DHIC的老年患者的有效选择。报告的不良事件轻微且不常见。
