PDF(Pubmed)
Abstract：
Background/Objectives: Data on the long-term effects of oxybutynin in patients with neurogenic bladder (NGB) due to spinal cord injury (SCI) are limited. This study aimed to evaluate the long-term effects of oxybutynin and the combination of oxybutynin with trospium in these patients, under real-world medical conditions. Methods: A total of 107 patients with NGB due to SCI were included. The mean treatment duration was 2.8 years ± 0.8 years. The patients were categorized into three groups: (1) low-dose oxybutynin (5-15 mg/day), (2) high-dose oxybutynin (20-40 mg/day), and (3) oxybutynin combined with trospium. The main outcomes were maximal detrusor pressure (MDP) and cystometric bladder capacity (CBC). Both were assessed at baseline and at three subsequent follow-up visits. Generalized estimation equation models were used to estimate the overall mean reduction in MDP and CBC for each group. Results: The overall adjusted mean reduction from baseline of MDP in groups 1, 2, and 3 were 2.5 (95% CI: -5.4 to 10.4; p = 0.540), 16.9 (95% CI: 4.4 to 29.4; p = 0.008), and 21.9 (95% CI: 4.1 to 39.8; p = 0.016) cmH2O, respectively. For the CBC, the mean reduction was not significant in any group at any visit, nor were the overall mean reductions. Conclusions: These findings suggest that high-dose oxybutynin and oxybutynin-trospium combination achieve a significant long-term reduction in MDP in patients with NGB after SCI. The effects were sustained across all three follow-up periods.
摘要：
背景/目标：关于奥昔布宁对脊髓损伤（SCI）引起的神经源性膀胱（NGB）患者的长期影响的数据有限。本研究旨在评估奥昔布宁和奥昔布宁与曲司的组合对这些患者的长期影响。在现实世界的医疗条件下。方法：共纳入107例SCI所致NGB患者。平均治疗时间为2.8年±0.8年。患者分为三组：（1）低剂量奥昔布宁（5-15毫克/天），（2）大剂量奥昔布宁（20-40毫克/天），(3)奥昔布宁与曲司匹铵合用。主要结果是最大逼尿肌压力（MDP）和膀胱膀胱容量（CBC）。两者都在基线和随后的三次随访时进行评估。使用广义估计方程模型来估计每组MDP和CBC的总体平均减少。结果：第1、2和3组MDP相对于基线的总体校正平均减少为2.5（95％CI：-5.4至10.4；p=0.540），16.9（95%CI：4.4至29.4；p=0.008），和21.9(95%CI：4.1至39.8；p=0.016)cmH2O，分别。对于CBC来说，在任何访问中，任何组的平均减少都不显著，总体平均降幅也不是。结论：这些发现表明，高剂量奥昔布宁和奥昔布宁-曲司铵联合治疗可在SCI后NGB患者中实现MDP的长期显着降低。这些影响在所有三个随访期内都持续存在。
