Nitric Oxide Donor for Urethral Pressure Profilometry in Evaluation of Urethral Function in Patients with Voiding Dysfunction

使用一氧化氮生成劑尿道壓力測量評估具排尿障礙病人之尿道功能

彭崇信(Chung-Hsin Peng) ； 郭漢崇(Hann-Chorng Kuo)

《慈濟醫學雜誌》 16卷4期 (2004/08) Pp. 211-216

https://doi.org/10.6440/TZUCMJ.200408.0211

摘要

目的：對具有排尿障礙之病人評估舌下一氧化氮生成劑之尿道壓力反應。病人與方法：五十位具有各式排尿障礙的病人以及十位具真性應力性尿失禁的女性接受此一研究，所有的病人先接受連續三次尿道壓力測量，然後給予舌下用0.6 mg glyceryl trinitrate，2分鐘後再進行連續三次的尿道壓力測量。最大尿道閉鎖壓力(MUCP)及功能性尿道長度(FPL)以三次檢查平均數，並比較在各組病人之治療前後之改變。結果：MUCP在治療後改變最大是曾經接受根治性子宮全切除具逼尿肌收縮力低下的病人群(38.5±16.5%)減少，尿失禁病人次之(27.9±13.4%)。在具有MUCP減少25%以上的20名排尿障礙病人，給予舌下服用glyceryl trinitrate四週後，14名(70%)自覺排尿變為輕鬆。這些病人阻塞性症狀積分(17.5±2.7 vs 13.9±2.46, p=0.000)及最大尿流速(11.5±4.9 vs 13.1±5.4, p=0.002)，在治療數均具有顯著的改善。結論：本研究證實給予一氧化氮生成劑對於人類可以放鬆尿道外括約肌，並改善其排尿困難的症狀。

關鍵字

一氧化氮 ； 尿道外括約肌 ； 排尿障礙 ； 尿道阻力

並列摘要

Objective: To investigate the urethral response to sublingual nitric oxide donor in patients with voiding dysfunction. Patients and Methods: Fifty patients with difficulties urinating due to various etiologies and 10 women with genuine stress urinary incontinence (SUI) were included in the study. All of these patients initially underwent three consecutive urethral pressure profilometries (UPP), then 0.6 mg glyceryl trinitrate was given sublingually, and another three consecutive UPP studies were performed 2 minutes later after the administration of the glyceryl trinitrate. The maximal urethral closure pressure (MUCP) and functional profile length (FPL) were averaged from the three consecutive studies and compared between the baseline and post-treatment in each group of patients with voiding dysfunction. Results: The mean percentage reduction in MUCP was the greatest for the patients with detrusor underactivity who had undergone radical hysterectomy (38.5*16.6%), followed by patients with SUI (27.9±13.4%). Among the 20 patients with a 25% reduction in MUCP, 14 (70%) perceived improvement in voiding efficiency after medication with sublingual glyceryl trinitrate when they felt difficulty in urination. Among these 14 patients, the obstructive symptom score (17.5*2.7 vs 13.9± 2.5, p＜ 0.0001) and maximum flow rate (11.5±4.9 vs 13.1±5.4 mL/s, p= 0.002) showed a small but significant improvement after treatment. Conclusions: The results of this study demonstrated that supplementation of a nitric oxide donor can relax urethral sphincter in humans and relieve the symptoms of voiding dysfunction.

並列關鍵字

nitric oxide ； urethral sphincter ； voiding dysfunction ； urethral resistance