PDF(Pubmed)
Abstract：
The aim of the present study was to determine the relationship between dose of oxybutynin and reduction in detrusor pressure in individuals with neurogenic bladder (NGB) secondary to spinal cord injury (SCI). The hospital-based data were examined for all individuals with NGB and SCI who were admitted for urological evaluation between January 1999 and December 2016. Patient characteristics, urodynamics and bladder management details were collected at pre-treatment and post-treatment. The primary outcome used to assess oxybutynin treatment was the change in detrusor pressure (Pdet). Analysis of covariance (ANCOVA) was used to investigate the relationship between dosage of oxybutynin and decrease in Pdet. A total of 245 participants (112 who received no medication and 133 treated with oxybutynin) were included. After controlling for confounding factors, each 1 mg increase in oxybutynin was associated with a mean decrease of 0.9 cmH2O in Pdet (95% CI, -1.4 to -0.3). Stratifying bladder management by indwelling catheter, oxybutynin at a dose of 1 mg was associated with a mean decrease in Pdet of 0.5 cmH2O (95% CI, -1.4 to 0.4) in patients with indwelling catheters and 1.0 cmH2O (95% CI, -1.7 to -0.3) in patients with clean intermittent catheterization and balanced bladder. This study provided guidance for setting the starting dose of drugs associated with response variability in NGB with SCI. Oxybutynin is deemed to be clinically effective for managing NGB in patients with SCI.
摘要：
本研究的目的是确定奥昔布宁的剂量与脊髓损伤（SCI）继发神经源性膀胱（NGB）患者逼尿肌压力降低之间的关系。在1999年1月至2016年12月期间接受泌尿外科评估的所有NGB和SCI患者的医院数据进行了检查。患者特征,在治疗前和治疗后收集尿动力学和膀胱管理细节.用于评估奥昔布宁治疗的主要结果是逼尿肌压（Pdet）的变化。使用协方差分析（ANCOVA）来研究奥昔布宁的剂量与Pdet减少之间的关系。总共包括245名参与者（112名没有接受药物治疗，133名接受奥昔布宁治疗）。在控制了混杂因素后，奥昔布宁每增加1mg,Pdet中平均减少0.9cmH2O(95%CI,-1.4~-0.3).通过留置导尿管对膀胱进行分层管理，奥昔布宁1mg与留置导尿管患者的Pdet平均下降0.5cmH2O(95%CI,-1.4~0.4)相关,清洁间歇导尿管和平衡膀胱患者的Pdet平均下降1.0cmH2O(95%CI,-1.7~-0.3)相关.这项研究为设定与SCI患者NGB反应变异性相关的药物起始剂量提供了指导。奥昔布宁被认为对SCI患者的NGB管理是临床有效的。
