药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2015年
2期
134-137
,共4页
膀胱,过度活动性%毒蕈碱拮抗剂%琥珀酸索利那新
膀胱,過度活動性%毒蕈堿拮抗劑%琥珀痠索利那新
방광,과도활동성%독심감길항제%호박산색리나신
Urinary bladder,overactive%Muscarinic antagonists%Solifenacin succinate
膀胱过度活动症（ OAB ）是一组以尿急症状为特征的症候群，严重影响患者的生活质量。琥珀酸索利那新为新一代毒蕈碱型乙酰胆碱受体（M受体）拮抗剂，对于膀胱逼尿肌具有高选择性，可明显缓解OAB患者尿急、尿失禁症状，增加其每次排尿量、减少其排尿次数；可改善输尿管支架植入术后患者的下尿路症状。M受体拮抗剂的主要不良反应为口干、认知功能损害和尿潴留。与奥昔布宁、托特罗定等M受体拮抗剂比较，琥珀酸索利那新的口干和尿潴留发生率低，对认知功能的影响小，但对于存在高危因素（如联用其他抗胆碱药、基础疾病造成血脑屏障通透性改变等）或既往有不同程度认知损害的老年患者则存在诱发或加重认知功能损害的风险。服用琥珀酸索利那新的第1个月应密切关注患者残余尿量的变化，以降低急性尿潴留的风险。
膀胱過度活動癥（ OAB ）是一組以尿急癥狀為特徵的癥候群，嚴重影響患者的生活質量。琥珀痠索利那新為新一代毒蕈堿型乙酰膽堿受體（M受體）拮抗劑，對于膀胱逼尿肌具有高選擇性，可明顯緩解OAB患者尿急、尿失禁癥狀，增加其每次排尿量、減少其排尿次數；可改善輸尿管支架植入術後患者的下尿路癥狀。M受體拮抗劑的主要不良反應為口榦、認知功能損害和尿潴留。與奧昔佈寧、託特囉定等M受體拮抗劑比較，琥珀痠索利那新的口榦和尿潴留髮生率低，對認知功能的影響小，但對于存在高危因素（如聯用其他抗膽堿藥、基礎疾病造成血腦屏障通透性改變等）或既往有不同程度認知損害的老年患者則存在誘髮或加重認知功能損害的風險。服用琥珀痠索利那新的第1箇月應密切關註患者殘餘尿量的變化，以降低急性尿潴留的風險。
방광과도활동증（ OAB ）시일조이뇨급증상위특정적증후군，엄중영향환자적생활질량。호박산색리나신위신일대독심감형을선담감수체（M수체）길항제，대우방광핍뇨기구유고선택성，가명현완해OAB환자뇨급、뇨실금증상，증가기매차배뇨량、감소기배뇨차수；가개선수뇨관지가식입술후환자적하뇨로증상。M수체길항제적주요불량반응위구간、인지공능손해화뇨저류。여오석포저、탁특라정등M수체길항제비교，호박산색리나신적구간화뇨저류발생솔저，대인지공능적영향소，단대우존재고위인소（여련용기타항담감약、기출질병조성혈뇌병장통투성개변등）혹기왕유불동정도인지손해적노년환자칙존재유발혹가중인지공능손해적풍험。복용호박산색리나신적제1개월응밀절관주환자잔여뇨량적변화，이강저급성뇨저류적풍험。
Overactive bladder is a group of syndromes characterized by symptoms of urinary urgency,seriously affecting the quality of life of patients. Solifenacin succinate is a new generation of muscarinic acetylcholine receptor( M receptor)antagonist with high selectivity for detrusor,and it can not only obviously relieve the symptoms of urgency and incontinence,increase urination and reduce micturition frequency,but also improve lower urinary tract symptoms for patients after implantation of ureteral stents. The main adverse reactions of M receptor antagonist are dry mouth,cognitive impairment and urinary retention. Compared with oxybutynin and tolterodine,the incidences of dry mouth and urinary retention caused by solifenacin succinate are low,and it also has less effect on cognitive function. But for the patient with high risk factors( such as combined use of other anticholinergic drugs and changes of blood brain barrier caused by primary diseases)and elderly patients with a history of cognitive impairment can induce or worsen the risk of cognitive impairment. During the first month of taking solifenacin succinate,more attention should be paid on the changes of residual urine volume in order to reduce the risk of acute urinary retention.
