盐酸米多君治疗女性压力性尿失禁——尿垫试验和尿动力学观察

Effects of Midodrine on pad test and urodynamic parameters in women with stress urinary incontinence

目的 评价单次口服盐酸米多君对女性轻中度压力性尿失禁的治疗效果。 方法 采用开放的前瞻性临床研究设计,观察和比较 30例女性压力性尿失禁患者口服盐酸米多君前后尿垫试验和尿动力学检查结果的变化。 结果 患者服药前平均尿失禁量、Valsalva漏尿点压力、咳嗽漏尿点压力、最大尿道闭合压、功能性尿道长度分别为(9. 2±8. 6)g、(73. 7±22. 6)cmH2O(1cmH2O=0. 098kPa)、(97. 1±40. 4 )cmH2O、( 84. 9±45. 8 )cmH2O和 ( 3. 3±1. 0 )cm,服药后分别为(4. 0±5. 2)g、(84. 8±26. 9)cmH2O、(118. 6±36. 4)cmH2O、(105. 2±52. 3)cmH2O和 (3. 7±0. 9)cm,服药后平均尿失禁量减少(5. 3±5. 6)g(P<0. 01)。Valsalva漏尿点压力、咳嗽漏尿点压力分别增加(10. 7±16. 0)cmH2O、(21. 5±20. 8)cmH2O,差异均有统计学意义(P<0. 01)。最大尿道闭合压、功能性尿道长度分别增加(20. 3±47. 0)cmH2O、(0. 4±0. 9 )cm,差异有统计学意义 (P<0. 05)。 结论 尿垫试验和尿动力学观察表明,单次口服盐酸米多君对轻中度女性压力性尿失禁具有快速和客观的临床治疗效果。

Objective To evaluate the efficacy of single dosage of Midodrine hydrochloride in the treatment of women with stress urinary incontinence. Methods An open and prospective clinical study was conducted on 30 women with stress urinary incontinence. They all underwent pad test and urodynamic examination before and after oral use of Midodrine. Results Before oral use of Midodrine,the average quantity of urine loss,Valsalva leak point pressure,cough leak point pressure,maximum urethra closure pressure and functional urethral length were (9.2±8.6)g,(73.7±22.6)cm H 2O (1 cm H 2O = 0.098 kPa),(97.1±40.4)cm H 2O,(84.9±45.8)cm H 2O and(3.3±1.0)cm,respectively;while these parameters were (4.0±5.2)g, (84.8±26.9)cm H 2O, (118.6±36.4)cm H 2O,(105.2±52.3)cm H 2O and( 3.7± 0.9)cm after Midodrine use.Compared with those at baseline,the average quantity of urine loss after oral use of Midodrine was decreased by ( 5.3±5.6) g(P <0.01);Valsalva leak point pressure and cough leak point pressure were significantly increased by (10.7±16.0)cm H 2O and (21.5±20.8) cm H 2O,respectively (P<0.01).Maximum urethra closure pressure and functional urethral length were increased by( 20.3± 47.0)cm H 2O and (0.4±0.9) cm, respectively(P<0.05). Conclusions Midodrine hydrochloride at single dosage has rapid and objective effects on the urine loss and urodynamic parameters in women with mild to moderate stress urinary incontinence.