去氨加壓素能改善老年患者的重度夜尿症

尿液動力學試驗未能檢測出顯效的患者

  2002年4月17日-4月版《泌尿學》中報導的一項研究發現,65歲及65歲以上患者中2/3的患者,口服去氨加壓素能改善重度夜尿症。但早期尿液動力學試驗無法區分該療法對哪些患者有效。

  臺灣Buddhist Tzu Chi總醫院的Hann-Chorng Kuo醫師寫到:「去氨加壓素已被證實能有效減少夜尿的次數,改善生活品質而且副作用很少。」

  受試者包括5名女性和25名男性,平均年齡為75.4+6.6歲。他們接受了為期4周的口服去氨加壓素治療,每天睡前服用0.1mg。這些患者的夜尿次數為3次或3次以上,夜間多尿而且其他藥物療法不易控制。

  在治療期間,20名患者(66.7%)療效顯著,夜尿次數和尿量均減少,2名患者(6.7%)夜尿次數改善,3名患者(10%)無效。5名患者(16.7%)出現副作用,包括其中一名患者出現低鈉血症。

  停止去氨加壓素治療4周後,同治療初期相比,13名患者(52%)症狀改善,6名患者(24%)治療後,夜尿次數沒有發生變化。

  作者寫到:「尿液動力學試驗未能檢測出具有明顯效果的患者。」儘管這不是一個設有對照的試驗,但研究者斷定去氨加壓素能安全有效地治療65歲及65歲以上患者的重度夜尿症。

  

Desmopressin Improves Severe Nocturia in Elderly

Urodynamic Testing Does Not Predict Responders

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

April 17, 2002 -- Oral desmopressin improves severe nocturia in two-thirds of patients aged 65 years and older, according to a study reported in the April issue of Urology. Prior urodynamic testing did not distinguish those who responded from those who did not.

"Desmopressin has been shown to be effective in reducing nocturnal frequency and improving the quality of life with few side effects," writes Hann-Chorng Kuo, MD, from the Buddhist Tzu Chi General Hospital in Taiwan.

Five women and 25 men, mean age 75.4+6.6 years, received four weeks of treatment with oral desmopressin 0.1 mg at bedtime for nocturia three or more times nightly and nocturnal polyuria refractory to medication.

During treatment, 20 patients (66.7%) reported a good response with both reduced nocturnal frequency and urine volume, two (6.7%) had improved nocturnal frequency, and three (10%) reported no effect at all. Five patients (16.7%) reported side effects, including hyponatremia in one.

After discontinuing the medication for four weeks, 13 patients (52%) had improved symptoms relative to baseline and six (24%) remained at their post-treatment frequency of nocturia.

"No significant difference was found in the success rate relative to the urodynamic results," the authors write. Although this was not a controlled trial, they concluded that desmopressin is "safe and effective in the treatment of severe nocturia in patients 65 years old and older."

© 2002 WebMD Inc. All rights reserved.

    



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