CAJ | 학술논문

目的观察小剂量口服醋酸去氨加压素治疗老年女性夜间尿量增多型夜尿的疗效和安全性. 方法 2009年8月至2011年6月女性夜间尿量增多型夜尿患者97例.年龄60～86岁,平均(72±7)岁.随机分为2组,实验组49例,夜间排尿量为(590±70) ml,平均夜尿次数为2.9次,每天睡前服用0.1 mg醋酸去氨加压素片,同时限制夜间饮水量＜100 ml;对照组48例,夜间排尿量为(600±90)ml,平均夜尿次数为2.8次,仅限制夜间饮水量＜100 ml.疗程8周.患者在治疗过程中持续记录排尿日记.治疗4、8周后分别测量平均夜间排尿量、平均夜尿次数、平均第一睡眠周期时间及睡眠质量.治疗前所有患者的血清钠、肝肾功能指标均在正常范围,治疗4、8周后,均复查血生化.结果治疗4周后,实验组夜尿次数＜2次者28例(57.1％),对照组15例(31.3％),组间比较差异有统计学意义(P＜0.05).治疗8周后,实验组夜尿次数＜2次者35例(71.4％),对照组16例(33.3％),组间比较差异有统计学意义(P＜0.05).治疗8周后,实验组夜间排尿量为(376±50) ml,平均夜尿次数为1.6次,与治疗前比较差异均有统计学意义(P＜0.05)；对照组夜间排尿量为(550±60)ml,平均夜尿次数为2.3次,与治疗前比较差异均无统计学意义(P＞0.05)；平均第一睡眠周期时间实验组由2.2h增至3.8h,对照组由2.1h增至2.5h,两组比较差异有统计学意义(P＜0.05).治疗8周后,实验组39例(79.6％)睡眠质量评分≤2分,对照组15例(31.3％),两组比较差异有统计学意义(P＜0.05).治疗过程中所有患者的血清钠、肝肾功能指标均在正常范围.实验组3例发生轻度头痛、恶心、呕吐等药物相关不良反应,未停药自行缓解.对照组除夜间口渴外,无其他不良反应报告. 结论小剂量口服醋酸去氨加压素治疗老年女性夜间尿量增多型夜尿安全有效.
목적 관찰소제량구복작산거안가압소치료노년녀성야간뇨량증다형야뇨적료효화안전성. 방법 2009년8월지2011년6월녀성야간뇨량증다형야뇨환자97례.년령60～86세,평균(72±7)세.수궤분위2조,실험조49례,야간배뇨량위(590±70) ml,평균야뇨차수위2.9차,매천수전복용0.1 mg작산거안가압소편,동시한제야간음수량＜100 ml;대조조48례,야간배뇨량위(600±90)ml,평균야뇨차수위2.8차,부한제야간음수량＜100 ml.료정8주.환자재치료과정중지속기록배뇨일기.치료4、8주후분별측량평균야간배뇨량、평균야뇨차수、평균제일수면주기시간급수면질량.치료전소유환자적혈청납、간신공능지표균재정상범위,치료4、8주후,균복사혈생화.결과 치료4주후,실험조야뇨차수＜2차자28례(57.1％),대조조15례(31.3％),조간비교차이유통계학의의(P＜0.05).치료8주후,실험조야뇨차수＜2차자35례(71.4％),대조조16례(33.3％),조간비교차이유통계학의의(P＜0.05).치료8주후,실험조야간배뇨량위(376±50) ml,평균야뇨차수위1.6차,여치료전비교차이균유통계학의의(P＜0.05)；대조조야간배뇨량위(550±60)ml,평균야뇨차수위2.3차,여치료전비교차이균무통계학의의(P＞0.05)；평균제일수면주기시간실험조유2.2h증지3.8h,대조조유2.1h증지2.5h,량조비교차이유통계학의의(P＜0.05).치료8주후,실험조39례(79.6％)수면질량평분≤2분,대조조15례(31.3％),량조비교차이유통계학의의(P＜0.05).치료과정중소유환자적혈청납、간신공능지표균재정상범위.실험조3례발생경도두통、악심、구토등약물상관불량반응,미정약자행완해.대조조제야간구갈외,무기타불량반응보고. 결론 소제량구복작산거안가압소치료노년녀성야간뇨량증다형야뇨안전유효.
Objective To investigate the efficacy and safety of low dose of oral desmopressin in elderly women with nocturia. Methods Eligible female patients with nocturia older than 60 years were included in this study.A total of 97 patients were randomly divided into 2 groups.Care was taken to match the patients of the two groups by age and clinical criteria.Control group (n=48 ) received liquid restriction during nighttime.Experimental group (n=49) received 0.1 mg desmopressin at bedtime and liquid restriction for 8 weeks.Patients were required to visit the outpatient clinic from the first visit,and after 4 and 8 weeks of treatment.Patients maintained flow volume charts and used diaries to record voiding data throughout the study.At each visit,all patients were evaluated by blood biochemical routine test,mean nocturnal urine volume,mean number of nocturia,mean duration of the first sleep period and sleep quality.At baseline,all the patient's blood sodium,liver and kidney function were normal. Results After 4 weeks of treatment with desmopressin,28 patients (57.1％) had less than 2 voids.15 patients (31.3％) in the control group had less than 2 voids.After 8 weeks,35 patients (71.4％) with desmopressin had less than 2 voids.16 patients (33.3％) in the control group had less than 2 voids.Compared with control group,nocturia cure rate in experimental group was significantly higher after 4 weeks and 8 weeks (P ＜ 0.05).After 8weeks,desmopressin significantly decreased mean nocturnal urine output from 590 ± 70 ml to 376 ± 50 ml (P ＜ 0.05).Mean nocturnal urine output in the control group was not significantly decreased from 600 ± 90 ml to 550 ± 60ml (P ＞0.05) ; Mean number of nocturia before and after receiving desmopressin were 2.9 and 1.6 respectively which differed significantly (P ＜ 0.05).Mean number of nocturia before and after in control group were 2.8 and 2.3 respectively with no significant difference (P ＞ 0.05).The mean duration of the first sleep period increased by 73％ (from 2.2 to 3.8 h) in the desmopressin group,compared with an increase of 19％ (from 2.1 to 2.5 h) in the control group (P ＜ 0.05).39 (79.6％) patients in demopressin group were satisfied with sleep quality compared with only 15 (31.3％) patients in control group were satisfied (P ＜ 0.05).No serious complications were found during the medication.All the patient's blood sodium,liver and kidney function remained normal during treatment. Conclusions Low does oral administration of desmopressin could be an effective and well-tolerated treatment for nocturnal polyuria in elderly women.