Morales A, Emerson L, Nickel J C
Department of Urology, Queen's University, Kingston, Ontario, Canada.
Urology. 1997 May;49(5A Suppl):111-3. doi: 10.1016/s0090-4295(97)00183-0.
On the assumption that interstitial cystitis (IC) is the result of a defective mucous lining of the bladder epithelium, a study was carried out to investigate the activity of hyaluronic acid (HA) in the treatment of IC. HA is an important glycosaminoglycan (GAG) present in all connective tissues, including the GAG layer of the vesical mucosa. It exhibits a variety of pharmacologic properties that enhance its appeal for the therapy of IC.
A total of 25 patients, with the characteristic picture of IC and refractory to other medical treatments, participated in a trial of HA. Patients received 40 mg of HA intravesically on a weekly basis for 4 weeks, then monthly. Response to therapy was evaluated by symptom score, voiding diaries, and visual analog scales.
An initial positive (complete+partial) response of 56% at week 4 increased to 71% by week 12. This response was maintained until week 20; beyond week 24 there appears to be a moderate decrease in the effectiveness of the medication. There was no significant toxicity attributable to the presence of HA in the bladder.
The response of refractory IC patients to the intravesical administration of HA was gratifying. In the past, many therapies for IC that were initially considered promising failed the test of a controlled study. Further studies will establish the effectiveness of this particular preparation of HA in the treatment of IC.
基于间质性膀胱炎（IC）是膀胱上皮黏膜层缺陷所致这一假设，开展了一项研究以调查透明质酸（HA）治疗IC的效果。HA是一种重要的糖胺聚糖（GAG），存在于包括膀胱黏膜GAG层在内的所有结缔组织中。它具有多种药理特性，这增强了其对IC治疗的吸引力。
共有25例具有IC典型症状且对其他治疗方法无效的患者参与了HA试验。患者每周膀胱内注射40mg HA，共4周，之后每月注射一次。通过症状评分、排尿日记和视觉模拟量表评估治疗反应。
第4周时初始阳性（完全缓解+部分缓解）反应率为56%，到第12周时升至71%。该反应一直维持到第20周；24周后药物疗效似乎有适度下降。膀胱内HA的存在未导致明显毒性。
难治性IC患者对膀胱内注射HA的反应令人满意。过去，许多最初被认为有前景的IC治疗方法在对照研究的检验中失败了。进一步的研究将确定这种特定HA制剂治疗IC的有效性。
