米拉贝隆对非肌层浸润性膀胱癌患者术后膀胱灌注的影响  

Effects of mirabegron on postoperative bladder perfusion in patients with non-muscle invasive bladder cancer

作　　者：王楷峰 田伟 何建松 李王坚 陈永良 WANG Kai-feng;TIAN Wei;HE Jian-song;LI Wang-jian;CHEN Yong-liang(Department of Urology,Shaoxing Central Hospital/China Medical University Shaoxing Hospital,Shaoxing ZHEJIANG 312030,China)

机构地区：[1]绍兴市中心医院/中国医科大学绍兴医院泌尿外科,浙江绍兴312030

出　　处：《中国新药与临床杂志》2024年第2期138-142,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：浙江省医药卫生科技计划项目(2020KY989,2022KY1315);浙江省医学会临床科研基金项目(2019ZYC-A146)。

摘　　要：目的评价米拉贝隆改善非肌层浸润性膀胱癌患者术后膀胱灌注药物保持时间和下尿路症状的有效性和安全性。方法选取接受经尿道膀胱肿瘤切除术非肌层浸润性膀胱癌患者42例,随机分为米拉贝隆组(米拉贝隆50 mg qd)、托特罗定组(托特罗定2 mg bid)和对照组(安慰剂),每组14例。观察3组术后8周内膀胱灌注药物保持时间、膀胱过度活动症评分(OABSS)和排尿后残余尿量(PVR)、最大尿流率(Q_(max))以及用药周期内不良反应发生情况。结果米拉贝隆组和托特罗定组术后4周内膀胱灌注药物保持时间、OABSS均显著优于对照组(P<0.05),且在术后8周内组间比较均无显著差异(P>0.05)。术后8周内米拉贝隆组PVR均显著优于托特罗定组(P<0.05),与对照组比较均无显著差异(P>0.05)。米拉贝隆组术后1~2周Q_(max)显著大于托特罗定组(P<0.05),且与对照组比较无显著差异(P>0.05)。用药周期内,米拉贝隆组未出现头晕、口干不良反应,仅出现1例便秘,且与对照组比较无显著差异(P>0.05)。结论米拉贝隆能改善非肌层浸润性膀胱癌患者术后膀胱灌注药物保持时间和OABSS,且不增加不良反应发生率、不影响排尿期膀胱逼尿肌收缩,安全性较好。AIM To evaluate the efficacy and safety of mirabegron in improving postoperative bladder perfusion drug retention time and lower urinary tract symptoms in patients with non-muscle invasive bladder cancer(NMIBC).METHODS A total of 42 NMIBC patients who underwent transurethral resection of bladder tumor were selected and randomly divided into mirabegron group(mirabegron 50 mg qd),tolterodine group(tolterodine 2 mg bid),control group,and each group had 14 cases.The bladder perfusion drug retention time,overactive bladder syndrome score(OABSS),postvoid residual(PVR),maximum urine flow rate(Q_(max))and the incidence of adverse reactions were observed in three groups after operation.RESULTS The bladder perfusion drug retention time and OABSS in the mirabegron group,tolterodine group were better than those in the control group within 4 weeks after operation(P<0.05),and were similar within 8 weeks between the experiment groups(P>0.05).The PVR in the mirabegron group was better than that in the tolterodine group within 8 weeks after operation(P<0.05),and without statistically significant difference compared with the control group(P>0.05).The Q_(max) in the mirabegron group was better than that in the tolterodine group within 2 weeks after operation(P<0.05),and without statistically significant difference compared with the control group(P>0.05).During the medication period,there were no adverse reactions such as dizziness or dry mouth in the mirabegron group,only one case of constipation occurred,and there was no significant difference compared to the control group(P>0.05).CONCLUSION Mirabegron can improve postoperative bladder perfusion drug retention time and OABSS in patients with NMIBC,without increasing the incidence of adverse reactions.Furthermore,mirabegron has the higher safety without affecting bladder detrusor contraction during urination compared with tolterodine.

关 键 词：米拉贝隆 托特罗定 膀胱肿瘤 膀胱 过度活动性 膀胱灌注 

分 类 号：R737.14[医药卫生—肿瘤] R983[医药卫生—临床医学]