背景:良性前列腺增生(BPH)可导致逼尿肌肥大和膀胱功能恶化,其收缩活动降低。文献中介绍了许多出版物,其结果表明α-受体阻滞剂降低膀胱肥大的可能性。
目的:进行回顾性分析,研究阿福前列素MR对尿动力学参数的影响,以及治疗对BPH引起的逼尿肌肥大和膀胱出口梗阻患者逼尿肌厚度和膀胱质量的影响。
方法:回顾了30例BPH引起的下尿路症状(LUTS)患者的门诊记录,这些患者接受了AlfuprostMR作为单一治疗24周。根据日记,评估了以下参数:IPSS总分,IPSS作废(问题号1、3、5和6)和存储子量表得分(问题号2、4和7),根据尿流量测定的最大流量(Qmax),前列腺的体积和残余空隙(通过超声评估),对生活质量评分(QoL)的治疗满意度,以及逼尿肌厚度和膀胱质量指数的变化。
结果:LUTS严重程度的改善,从治疗的第4周开始,随后是一个积极的趋势,一直持续到阿福前列素MR治疗的第24周,找到了。到治疗第24周,总体平均IPSS评分提高了39.0%。同时,排尿症状改善46.8%,治疗24周后,储存症状改善了30.9%。治疗24周后,平均Qmax显着增加(p<0.05)22.1%。逼尿肌平均厚度减少了40,2%。膀胱质量指数平均显著下降34,3%(p<0.05)。治疗24周后QoL评分显著改善2.2分(p<0.05)。
结论:在BPH患者的24周治疗期间,阿福前列素MR不仅在减少排尿症状和改善QoL方面表现出临床疗效,而且对逼尿肌肥大也有积极作用,逼尿肌厚度和膀胱质量指数的变化证明了这一点。没有任何不良事件,包括血压和心率的下降,允许我们推荐AlfuprostMR作为与BPH相关的LUTS的有效治疗方法,减少逼尿肌肥大,具有高安全性和最小的血管舒张作用。
BACKGROUND: Benign prostatic hyperplasia (BPH) can lead to the detrusor hypertrophy and deterioration of the bladder function with a decrease in its contractile activity. A number of publications are presented in the literature, the results of which indicate the possibility of reducing bladder hypertrophy with alpha-blockers.
OBJECTIVE: To carry out the retrospective analysis to study the effect of Alfuprost MR on urodynamic parameters, as well as the influence of the therapy on detrusor thickness and bladder mass in patients with detrusor hypertrophy and bladder outlet obstruction caused by BPH.
METHODS: Outpatient records of 30 patients with lower urinary tract symptoms (LUTS) caused by BPH who received Alfuprost MR as monotherapy for 24 weeks were reviewed. Based on the diaries, the following parameters were assessed: total IPSS score, IPSS voiding (questions No. 1, 3, 5 and 6) and storage subscale scores (questions No. 2, 4 and 7), maximum flow rate (Qmax) according to uroflowmetry, the volume of the prostate and the postvoid residual (assessed by ultrasound), satisfaction with treatment on the quality-of-life score (QoL), as well as the changes in detrusor thickness and bladder mass index.
RESULTS: An improvement in LUTS severity, starting from the 4th week of treatment, followed by a positive trend that persists until the 24th week of therapy with Alfuprost MR, was found. The overall average IPSS score improved by 39.0% by the 24th week of therapy. At the same time, voiding symptoms improved by 46.8%, and storage symptoms improved by 30.9% by 24 weeks of therapy. The average Qmax increased significantly (p<0.05) by 22.1% after 24 weeks of therapy. The average detrusor thickness decreased by 40,2%. Bladder mass index decreased significantly by an average of 34,3% (p<0.05). QoL score improved significantly (p<0.05) by 2.2 points after 24 weeks of therapy.
CONCLUSIONS: During the 24-week treatment of patients with BPH, Alfuprost MR demonstrated clinical efficacy not only in reducing voiding symptoms and in improving the QoL, but also a positive effect on detrusor hypertrophy, as evidenced by changes in detrusor thickness and bladder mass index. The absence of any adverse events, including decrease in blood pressure and heart rate, allows us to recommend Alfuprost MR as an effective treatment for LUTS associated with BPH, which reduces detrusor hypertrophy and has a high safety profile and minimal vasodilating effects.