米拉贝隆对输尿管远端结石的排石疗效观察  

Observation on Efficacy of Mirabegron in Medical Expulsive Therapy for Distal Ureteral Calculus

作　　者：杨江华[1] 廖晓星 赵延朋[1] 崔功静 YANG Jianghua;LIAO Xiaoxing;ZHAO Yanpeng;CUI Gongjing(Dept.of Urinary Surgery,Beijing Aerospace General Hospital,Beijing 100076,China;Dept.of Urinary Surgery,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijin 100029,China)

机构地区：[1]北京航天总医院泌尿外科,北京100076 [2]北京中医药大学第三附属医院泌尿外科,北京100029

出　　处：《中国医院用药评价与分析》2020年第10期1164-1167,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：首都临床特色临床研究项目(No.Z171100001017131)。

摘　　要：目的:探讨米拉贝隆治疗输尿管远端结石的疗效。方法:选取2019年1月至2020年5月于北京航天总医院诊断为输尿管远端结石患者,按结石直径分为A组(直径≤5.0 mm)、B组(直径5.0~10.0 mm)。A、B组通过完全随机法再分为三组(A1、A2和A3;B1、B2和B3)。A1和B1组患者给予米拉贝隆联合双氯芬酸钠治疗,A2和B2组患者给予盐酸坦索罗辛联合双氯芬酸钠治疗,A3和B3组患者给予双氯芬酸钠治疗。除去失访、采取其他治疗方案,最终共188例患者完成本研究。其中A组95例(A1组33例,A2组31例,A3组31例);B组93例(B1组31例,B2组30例,B3组32例)。观察4周,比较各亚组间排石率、排石时间、肾绞痛发作次数及膀胱刺激症状评分的差异。结果:A1、B1患者的肾绞痛发作次数、膀胱刺激症状相关评分明显低于同组内其他亚组,差异均有统计学意义(P<0.05)。B1组患者较B3组排石率更高,差异有统计学意义(P<0.05);B1与B2组患者的排石率比较,差异无统计学意义(P>0.05)。结论:米拉贝隆用于直径<10.0 mm的输尿管远端结石患者,可有效改善膀胱刺激症状和肾绞痛发作次数,效果优于盐酸坦索罗辛;且米拉贝隆提高了直径为5.0~10.0 mm的输尿管远端结石患者的排石率。OBJIECTIVE:To probe into the efficacy of mirabegron in medical expulsive therapy for distal ureteral calculus.METHODS:Patients diagnosed with distal ureteral calculus in Beijing Aerospace General Hospital from Jan.2019 to May 2020 were divided into group A(diameter≤5.0 mm)and group B(diameter 5.0-10.0 mm)according to the diameter of calculus.Groups A and group B were divided into three groups(A1,A2 and A3;B1,B2 and B3)via completely random method.Group A1 and group B1 were given mirabegron combined with diclofenac sodium,group A2 and group B2 were given tamsulosin hydrochlorid combined with diclofenac sodium,group A3 and group B3 were treated with diclofenac sodium.Except for the loss to follow-up and other treatment options,a total of 188 patients finally completed the research.Of which 95 cases in group A(33 cases in group A1,31 cases in group A2,31 cases in group A3);93 cases in group B(31 cases in group B1,30 cases in group B2,and 32 cases in group B3).After 4 weeks of observation,differences in the rate of calculus removal,time of calculus removal,frequency of renal colic and score of bladder irritation were compared among the subgroups.RESULTS:The frequency of renal colic and score of bladder irritation of group A1 and group B1 were significantly lower than those of other subgroups in the same group,with statistically significant differences(P<0.05).The calculus-removal rate of group B1 was higher than that of group B3,with statistically significant difference(P<0.05);there was no statistical significance in difference in calculus-removal rates between group B1 and group B2(P>0.05).CONCLUSIONS:The application of mirabegron for patients with distal ureteral calculi with a diameter of less than 10.0 mm can effectively improve the symptoms of bladder irritation and frequency of renal colic,which has better effect than that of tamsulosin hydrochloride;and mirabegron has increased the calculus-removal rate of distal ureteral calculus with diameter between 5.0-10.0 mm.

关 键 词：米拉贝隆 盐酸坦索罗辛 双氯芬酸钠 输尿管远端结石 药物排石治疗 

分 类 号：R983[医药卫生—药品]