索利那新替换托特罗定治疗膀胱过度活动症的临床观察

Observation of the efficiacy in patients with overactive bladder switching from tolterodine to solifenacin treatment

目的前瞻性观察索利那新治疗经过托特罗定治疗无效的膀胱过度活动症患者的疗效及安全性。方法30例符合OAB诊断的女性患者。服用托特罗定2mg,2次/d,4周以上,因症状无改善,替换为索利那新5mg,1次/d,4周。以患者主观感觉,自由尿流率参数[最大尿流率(Qmax)、平均尿流率(Qave)、排尿量(VV)]和膀胱过度活动症评分(OABSS)问卷表评价疗效,观察服药期间不良反应。结果 30例患者均完成4周的治疗,患者主观感觉有效14例,总有效率为46.7%,其中10例(33.3%)感觉效果显著,并表示愿意继续使用索利那新治疗。治疗后尿流率参数均较服药前改善,其中Qmax由治疗前的(14.4±2.3)ml/s增加到(19.8±3.9)ml/s,Qave由治疗前的(8.7±1.5)ml/s增加到(11.7±2.6)ml/s,VV由治疗前的(164.4±27.2)ml增加到(226.0±35.1)ml(P<0.05)。OABSS总评分和白天尿次、夜间尿次和尿急均不同程度改善(P<0.05),其中总评分和尿急症状改善显著(P<0.01)。不良反应发生率低,其中4例(13.3%)诉口干但可以耐受,未观察到严重不良反应。结论索利那新对于部分托特罗定治疗无效的膀胱过度活动症患者,仍可取得良好效果,而且患者的耐受性和依从性较好。

Objective To evaluate prospectively the effect and security of solifenacin in the overactive bladder patients that were invalid to toherodine. Methods 30 patients that matched OAB diagnosis were all females. They were treated with solifena- cin（ 5rag, qd, 4 weeks ） for they were invalid to tolterodine （ 2mg, bid, 〉 4 weeks ）, The outcomes were evahtated by patients＇ self-report, the free uroflometry parameters （ maximum urine streaming rate （Qmax） , average urine streaming rate （0ave） , row urine quantity （VV） and the OAB symptoms scores（OABSS）. The untoward effect were observed during the trail. Results All 30 patients completed the treatment for 4 weeks, 14 patients （46. 7% ） felt available including 10 patients （33.3%） felt evident and would like to continue use it. The characters of uroflowmetry were improved, Qmax was raised from （ 14. 4± 2. 3 ） ml/s to（ 19.8 ± 3.9 ） ml/s, 0ave was raised from （8.7±1. 5 ） ml/s to （ 11.7± 2.6） ml/s,and VV was raised from （ 164. 4 ± 27.2 ） ml to （226. 0 ± 35.1 ） ml （P 〈0.05）. The scores of general OABSS and Urgency reduced evidently（ P 〈 0. 01 ） , and the scores of day micturation and noctuma were reduced too（P 〈 0. 05 ）. The bad reaction incidence rate was low, 4 patients（ 13.3% ）felt thirsty, but can tolerate. No serious adverse reaction happened. Conclusion Among the patients that were not effective to tolterodine, Patients receiving solifenaein also had significant improvements in symptoms of OAB. Moreover patient＇s tolerance and the compliance is good.