Perkash I
Stanford University Medical Center, Palo Alto, California, USA.
J Spinal Cord Med. 1995 Oct;18(4):236-9.
A total of 28 male spinal cord injury (SCI) patients were enrolled in an open label study to evaluate the efficacy and safety of terazosin to improve voiding. All patients were started on 1 mg daily dose at bedtime. The dosage was gradually increased to 1-2 mg twice daily, depending upon patient tolerance and a minimum acceptable systolic blood pressure of 90 mm Hg. Urodynamic evaluation was done in 24 patients prior to and one week after a maximum tolerated dose was established for at least 48 hours. The maximum dose varied from 1 to 5 mg daily. Subjective improvement in voiding was noticed in 50 percent of patients. Objective assessment with urodynamics showed a mean drop in maximum voiding pressure of 35 cm H2O (range 9-65 cm H2O) in only 42 percent of patients. Subjective improvement in voiding occurred in 14 of 17 patients with absent detrusor sphincter dyssynergia. The drug was discontinued in three patients with side effects of syncope in one patient, lethargy in another and body rash in the third. Because the tolerance dose of terazosin is variable and the therapeutic response is unpredictable, urodynamic monitoring is recommended to accomplish a useful outcome.
共有28名男性脊髓损伤（SCI）患者参与了一项开放标签研究，以评估特拉唑嗪改善排尿的疗效和安全性。所有患者均在睡前开始服用每日1毫克的剂量。根据患者耐受性和最低可接受收缩压90毫米汞柱，剂量逐渐增加至每日两次，每次1 - 2毫克。在至少48小时确定最大耐受剂量之前和之后一周，对24名患者进行了尿动力学评估。最大剂量为每日1至5毫克。50%的患者排尿主观改善。尿动力学客观评估显示，仅42%的患者最大排尿压力平均下降35厘米水柱（范围9 - 65厘米水柱）。17例无逼尿肌括约肌协同失调的患者中有14例排尿主观改善。三名患者因副作用停药，一名患者出现晕厥，另一名患者出现嗜睡，第三名患者出现皮疹。由于特拉唑嗪的耐受剂量因人而异，治疗反应不可预测，建议进行尿动力学监测以取得有效结果。
