Kirby R S
St Bartholomew's Hospital, West Smithfield, London, UK.
Br J Clin Pract Suppl. 1994 May;74:23-8.
A number of studies have confirmed the beneficial effects of selective alpha 1-adrenoceptor inhibitors in patients with benign prostatic hyperplasia (BPH). Most produce clinically significant improvements in symptom scores and uroflow, although some of the shorter-acting agents often do so at the expense of adverse events. Doxazosin has a slower onset of action and longer plasma half-life than any other available selective alpha 1-adrenoceptor inhibitor, which may confer advantages in terms of tolerability over the more rapidly absorbed and eliminated selective alpha 1-adrenoceptor inhibitors. Doxazosin produces statistically significant increases in mean and maximum uroflow, as well as small but significant reductions in maximum voiding pressures and statistically significant improvements in symptoms of frequency, urgency, nocturia, reduced uroflow and sensation of incomplete emptying. Changes in uroflow and symptoms are similar in normotensive and hypertensive patients with BPH, and are accompanied in hypertensive patients by a statistically significant fall in blood pressure. Treatment is well tolerated in both normotensive and hypertensive patients. Doxazosin, by virtue of its unique pharmacological profile, is a valuable new treatment option for the many patients with mild to moderate bladder outflow obstruction due to BPH. It may be especially appropriate therapy for those considerable numbers of elderly men who have both hypertension and bladder outflow obstruction due to prostatic enlargement.
多项研究已证实选择性α1肾上腺素能受体抑制剂对良性前列腺增生(BPH)患者具有有益作用。大多数药物在症状评分和尿流率方面产生了具有临床意义的改善,尽管一些短效药物通常是以出现不良事件为代价才达到这种效果。与其他任何可用的选择性α1肾上腺素能受体抑制剂相比,多沙唑嗪起效较慢且血浆半衰期较长,这可能使其在耐受性方面优于吸收和消除更快的选择性α1肾上腺素能受体抑制剂。多沙唑嗪可使平均尿流率和最大尿流率在统计学上显著增加,同时使最大排尿压力小幅但显著降低,并使尿频、尿急、夜尿、尿流率降低和排尿不尽感等症状在统计学上有显著改善。在患有BPH的血压正常和高血压患者中,尿流率和症状的变化相似,且高血压患者的血压在统计学上有显著下降。血压正常和高血压患者对治疗的耐受性都很好。多沙唑嗪凭借其独特的药理学特性,对于许多因BPH导致轻度至中度膀胱出口梗阻的患者而言,是一种有价值的新治疗选择。对于大量同时患有高血压和因前列腺增生导致膀胱出口梗阻的老年男性来说,它可能是特别合适的治疗方法。