索利那新在托特罗定治疗失败的女性膀胱过度活动症中的应用效果

Application of solifenacin for female overactive bladder failed in tolterodine treatment

目的探讨索利那新对托特罗定治疗失败的女性膀胱过度活动症的临床疗效及安全性。方法2010年1—10月收治女性膀胱过度活动症患者48例，经托特罗定治疗失败后，改用索利那新，服药方法为5mg／次，1次／d，治疗时间为4周。以24h排尿次数、尿急次数、急迫性尿失禁次数、尿垫使用数量和夜尿次数以及膀胱状态感知度改善作为疗效判定指标，以观察治疗效果。结果服药4周后，24h排尿次数由治疗前的（8．7±1．5）次降至（7．2±2．5）次，24h尿急次数由治疗前（3．4±2．1）次降至（2．0±1．8）次，24h急迫性尿失禁次数由（2．4±1．8）次降至（1．5±1．2）次，夜尿次数由（2．1±1．8）次降至（1．2±0．8）次，24h尿垫使用数量由（2．2±1．6）片降至（1．4±0．8）片，治疗前后比较差异均有统计学意义（P〈0．05）。膀胱状态感知度改善者42例。1例因服药后发生头痛退出，2例因口干和便秘退出，余45例未发生严重不良反应。结论索利那新对托特罗定治疗失败的女性膀胱过度活动症的治疗安全有效。

Objective To investigate the clinical efficacy and safety of solifenacin for female overactive bladder （OAB） who failed in tolterodine treatment. Methods From Jan 2010 to Oct 2010, 48 cases of female OAB were treated with 5 mg/d solifenaein for 4 weeks after the failure of tolterodine treatment. The improvement of the perception of bladder condition as well as the mean numbers of day-time mieturition, urgency episodes, urge incontinence episode per day, nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. Results After 4-week solifenacin treatment, the mean num- bers of day-time micturition, urgency episodes, urge incontinence episode per day, nocturia and pads usage were respectively decreased from the baselines （ 8.7 ± 1.5 ） , （ 3.4 ± 2.1 ） , （2.4 ± 1.8） , （ 2.1 ± 1.8 ） and （2.2±1.6） to be （7.2±2.5）, （2.0±1.8）, （1.5 ±1.2）, （1.2±0.8） and （1.4±0.8）. The perception of bladder condition was improved in 42 cases. The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth. No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.