Swierzewski S J, Gormley E A, Belville W D, Sweetser P M, Wan J, McGuire E J
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
J Urol. 1994 Apr;151(4):951-4. doi: 10.1016/s0022-5347(17)35132-7.
We prospectively studied the effect of terazosin on bladder compliance in 12 spinal cord injured patients. All study patients had demonstrated previously poor compliance despite clean intermittent catheterization and maximum anticholinergic therapy. Patients were started on 5 mg. terazosin nightly for 4 weeks. They were evaluated with a history, physical examination, symptom score, and synchronous cystoscopy and cystometry before, during and after terazosin therapy. Detrusor compliance improved in all patients during the treatment phase. The change in bladder pressure and the safe bladder volume were statistically and clinically significant. Patients also reported fewer episodes of incontinence and dysreflexia. The improvement in compliance and continence suggests that in the spinal cord injured patient terazosin may have an effect on alpha receptors in the detrusor muscle or central effects and that improved compliance is not due to decreased outlet resistance.
我们前瞻性地研究了特拉唑嗪对12例脊髓损伤患者膀胱顺应性的影响。所有研究患者此前尽管进行了清洁间歇性导尿和最大剂量的抗胆碱能治疗，但膀胱顺应性仍较差。患者每晚开始服用5毫克特拉唑嗪，持续4周。在特拉唑嗪治疗前、治疗期间和治疗后，对患者进行病史、体格检查、症状评分以及同步膀胱镜检查和膀胱测压评估。在治疗阶段，所有患者的逼尿肌顺应性均有所改善。膀胱压力变化和安全膀胱容量在统计学和临床上均具有显著意义。患者还报告尿失禁和反射亢进发作次数减少。顺应性和尿失禁情况的改善表明，在脊髓损伤患者中，特拉唑嗪可能对逼尿肌中的α受体有作用或具有中枢效应，且顺应性的改善并非由于出口阻力降低。
