Administration of the selective alpha 1A-adrenoceptor antagonist silodosin facilitates expulsion of size 5-10 mm distal ureteral stones, as compared to control
Administration of the selective alpha 1A-adrenoceptor antagonist silodosin facilitates expulsion of size 5-10 mm distal ureteral stones, as compared to control
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DOI：
10.1007/s11255-013-0429-8
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发表时间：
2013-06-01
影响因子：
2
通讯作者：
Kohri, Kenjiro
中科院分区：
文献类型：
--
作者：
Itoh, Yasunori;Okada, Atsushi;Kohri, Kenjiro
最近，我们报道了α 1a -肾上腺素受体（AR）是苯肾上腺素诱导的人输尿管收缩的主要参与者。因此，我们决定开展一项前瞻性随机研究，以评估选择性α 1A AR拮抗剂西洛多辛作为输尿管远端结石的医学排出疗法（MET）的效果。选取112例转诊至我科治疗症状性单侧输尿管远端结石小于10mm的男性患者，随机分为两组：A组（56例）每日饮水2l， B组（56例）每日饮水2l，同时给予西洛多辛（8mg /d）治疗，最长4周。观察排出率、排出时间及镇痛药用量。A组排出率为55.3%（56例），B组为72.7%（55例）（P = 0.106）。< 5 mm排出率A组为92.9%（28例），B组为69.2%（26例）（P = 0.053）。a组排出率为17.9%（28例），B组为75.9%（29例）（P = 0.001）。排出时间分别为13.40 +/- A 5.90和9.29 +/- A 5.91 d （P = 0.012）。镇痛药需用次数分别为1.5 +/- A 3.1次和0.3 +/- A 0.9次（P = 0.382）。排尿组结石大小分别为3.64 +/- A 1.25 mm和5.23 +/- A 2.32 mm （P = 0.003）。结石大小已被确定为结石排出的重要预测因素。因此，与对照组相比，给予西洛多辛能够促进排出1.5毫米或更大的输尿管远端结石是很重要的。我们认为西洛多辛可能有潜力作为输尿管远端结石的MET。
Recently, we reported that alpha 1A-adrenoceptor (AR) is the main participant in phenylephrine-induced human ureteral contraction. We therefore decided to carry out a prospective randomized study to evaluate the effects of silodosin, a selective alpha 1A AR antagonist, as a medical expulsive therapy (MET) for distal ureteral stones.A total of 112 male patients, who were referred to our department for the management of symptomatic unilateral distal ureteral calculi of less than 10 mm, were randomly divided into two groups: group A (56 patients) who were instructed to drink 2 L of water daily and group B (56 patients) who received the same instruction and were also given silodosin (8 mg/daily) for a maximum of 4 weeks. Expulsion rate, expulsion time and need for analgesics were examined.The expulsion rate was 55.3 % (56 patients) for group A and 72.7 % (55 patients) for group B (P = 0.106). The expulsion rate for < 5 mm was 92.9 % (28 patients) for group A and 69.2 % (26 patients) for group B (P = 0.053). The expulsion rate for a parts per thousand yen5 mm was 17.9 % (28 patients) for group A and 75.9 % (29 patients) for group B (P = 0.001). The expulsion time was 13.40 +/- A 5.90 and 9.29 +/- A 5.91 days, respectively (P = 0.012). Analgesics were required 1.5 +/- A 3.1 and 0.3 +/- A 0.9 times, respectively (P = 0.382). Stone size in expulsion cases was 3.64 +/- A 1.25 and 5.23 +/- A 2.32 mm, respectively (P = 0.003).Stone size has been identified as an important predictive factor for stone expulsion. Therefore, it is important that administration of silodosin can facilitate expulsion of 1.5 mm or larger distal ureteral stones, as compared to control. We believe that silodosin might have potential as a MET for distal ureteral stones.