針對甲型阻滯劑治療男性夜尿有效的預測因子

李政霖ヽ李宇坤ヽ郭漢崇

花蓮慈濟醫院泌尿部

Predictive factors for effective therapeutic response to alpha-blocker therapy in male patients with nocturia

Cheng-Ling Lee, Yu-Khun Lee, Hann-Chorng Kuo

Department of Urology, Buddhist Tzu Chi Hospital, Hualien

Purpose: Lower urinary tract symptoms (LUTS) in men refer to dysfunction in  voiding, storage or both. Nocturia, in particular, has been shown adversely impact on quality of life and associated with an increassed risk of morbidity and even mortality in elderly. In this study, we evaluate the efficacy of adrenoceptor antagonist (α-blocker) in reducing nocturia episodes and identify factors predicting a successful outcome for nocturia in men with LUTS.Times New Roman.

Materials and Methods: A total of 348 men with LUTS were enrolled in this study. All participants were treated with a daily dose of α-blocker for 1 month. Subjects were then divided into 2 groups based on their number of reduction (NOR) in nocturia episodes: NOR <1 (non-responder) and NOR ≥ 1 (responder). Patients were evaluated at baseline and at the end of 1-month period using uroflowmetry, post-voiding residual (PVR), voided volume (VV), voiding efficiency (VE= VV/ [VV+PVR]), the Internationl Prostate Symptom Score (IPSS) and nocturia episodes.

Results:  In 348 men, there were 156 patients (44.8%) reported NOR ≥ 1 after taking 1-month daily dose of α-blocker. Baseline characteristics between non-responder and responder were summarized in Table.1. Those who responded well to α-blockade therapy have lower Qmax, worse storage symptoms and more nocturia episodes at baseline. VE in all patients were significantly improved at 1-month period. Those with greater NOR in nocturia episodes have lower VE at baseline (Table.2).

Conclusion: In this study, we have shown treatment of adrenoceptor antagonist can reduce nocturia episodes in men with LUTS. Worse storage symptoms, greater number of nocturia episodes, lower Qmax and poor VE at baseline could have better predicitve value for favourable outcome.