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长期去氨加压素治疗老年人夜间多尿症的效果。

Effects of long-term desmopressin treatment for nocturia in older people.

机构信息

Department of Urology, Chikugo City Hospital, Chikugo, Fukoka, Japan.

Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan.

出版信息

Int J Urol. 2024 Oct;31(10):1114-1120. doi: 10.1111/iju.15530. Epub 2024 Jul 15.

Abstract

OBJECTIVES

Desmopressin improves nocturia frequency; however, reports on its long-term efficacy and safety are few, and concerns regarding its effect on body composition exist. We thus investigated the efficacy and safety of long-term desmopressin administration and its effect on body composition.

METHODS

This retrospective study, conducted at Chikugo City Hospital between August 2020 and December 2022, involved 133 men (mean age, 77.7 years) with nocturnal and persistent nocturia, who were administered an initial dose of 50 μg desmopressin. Efficacy endpoints included nocturnal urinary frequency, nocturnal urinary volume, hours of undisturbed sleep, nocturnal polyuria index, initial nocturnal urinary volume, and daily urinary frequency in a frequency-volume chart (3 days), before treatment and at 1, 4, 12, 24, and 52 weeks after desmopressin administration. Additionally, the effects of desmopressin on body composition were examined, including blood-brain natriuretic peptide and a chest radiography, before and 52 weeks after administration.

RESULTS

Treatment improved most efficacy endpoint evaluation parameters. Around 87.6% of patients showed improved symptoms after 52 weeks compared with those before treatment (score ≤ 3). The blood-brain natriuretic peptide level rose; however, cardiothoracic ratio was unchanged.

CONCLUSION

Long-term administration of desmopressin is thus effective and safe in older people with nocturnal polyuria, with little effect on body composition.

摘要

目的

去氨加压素可改善夜尿频率;然而,关于其长期疗效和安全性的报告较少,并且存在对其对身体成分影响的担忧。因此,我们研究了长期给予去氨加压素的疗效和安全性及其对身体成分的影响。

方法

这项回顾性研究于 2020 年 8 月至 2022 年 12 月在筑后市医院进行,共纳入 133 名患有夜间和持续性夜尿症的男性患者(平均年龄 77.7 岁),给予初始剂量为 50μg 的去氨加压素。疗效终点包括夜间排尿频率、夜间排尿量、无干扰睡眠时间、夜间多尿指数、初始夜间排尿量和频率-容量图表中的每日排尿频率(3 天),在治疗前和给予去氨加压素后 1、4、12、24 和 52 周时进行评估。此外,还在给予去氨加压素前后检查了其对身体成分的影响,包括脑利钠肽和胸部 X 线。

结果

治疗改善了大多数疗效终点评估参数。与治疗前相比,大约 87.6%的患者在 52 周后症状得到改善(评分≤3)。脑利钠肽水平升高;然而,心胸比不变。

结论

对于夜间多尿的老年人,长期给予去氨加压素是有效且安全的,对身体成分影响较小。

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