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米拉贝隆在治疗远端输尿管结石的医学排出疗法中的应用:一项前瞻性、随机、对照研究。

Mirabegron in medical expulsive therapy for distal ureteral stones: a prospective, randomized, controlled study.

机构信息

Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China.

出版信息

World J Urol. 2021 Dec;39(12):4465-4470. doi: 10.1007/s00345-021-03772-9. Epub 2021 Jul 9.

Abstract

OBJECTIVE

To observe the efficacy and safety of Mirabegron in patients with distal, ureteral stones ≤ 10 mm.

PATIENTS AND METHODS

A total of 90 patients with distal ureteral stones ≤ 10 mm were prospectively randomized into two groups. Forty-five cases in the study group and 45 cases as control. The stone-free rates (SFRs) and renal colic episodes between two groups were compared at the 1st, 2nd and 4th week end by imaging examinations.

RESULT

All of 90 patients were randomly assigned to two groups. In patients with ≤ 5 mm stones, the SFRs in the 1st week (63.6% vs. 33.3%, P = 0.040), the 2nd week (86.4% vs. 54.2%, P = 0.018), and the 4th week (90.9% vs. 66.7%, P = 0.046) after treatment were all significantly higher than that in the control group by the stratification analysis of stone size. Even though SFRs were all higher for patients with > 5 mm stones in study group, there was no statistically significant difference (All P > 0.05). In terms of renal colic episodes, the frequency of occurrence of the study group was significantly lower than that of the control group and need less antalgic.

CONCLUSIONS

The MET with Mirabegron has a significant role in improve SFR for the patients with distal ureteral stones ≤ 5 mm and no effect in > 5 mm stones. Furthermore, Mirabegron reduces the need for antalgic in ≤ 10 mm stones with low incidence of adverse effects.

摘要

目的

观察米拉贝隆治疗远端输尿管结石 ≤ 10mm 的疗效和安全性。

患者和方法

前瞻性随机将 90 例远端输尿管结石 ≤ 10mm 的患者分为两组。研究组 45 例,对照组 45 例。通过影像学检查比较两组患者在第 1、2、4 周末的无结石率(SFR)和肾绞痛发作情况。

结果

90 例患者均被随机分为两组。对于 ≤ 5mm 结石患者,第 1 周(63.6% vs. 33.3%,P = 0.040)、第 2 周(86.4% vs. 54.2%,P = 0.018)及第 4 周(90.9% vs. 66.7%,P = 0.046)SFR 均显著高于对照组,根据结石大小分层分析。尽管研究组 > 5mm 结石患者的 SFR 均较高,但无统计学差异(均 P > 0.05)。肾绞痛发作方面,研究组发作频率明显低于对照组,需要的止痛药物更少。

结论

MET 联合米拉贝隆可显著提高远端输尿管 ≤ 5mm 结石患者的 SFR,对 > 5mm 结石无效。此外,米拉贝隆降低了 ≤ 10mm 结石患者对止痛药物的需求,且不良反应发生率低。

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