BMJ:α受体阻滞剂治疗输尿管结石,效果怎样?

2016-12-01 fsy MedSci原创

α受体阻滞剂治疗输尿管结石

来自美国的研究人员开展了一项系统回顾和荟萃分析,该研究的目的是探讨α-受体阻滞剂治疗输尿管结石患者的疗效。

研究人员参考了直到2016年7月的Cochrane对照试验登记,Web of Science,EMBASE,LILACS,和MEDLINE数据库以及科学会议摘要。

研究人员纳入了α阻滞剂与安慰剂或对照药物治疗输尿管结石的随机对照试验。两个团队成员独立提取每个纳入研究的数据。主要结果是排出结石患者的比例。次要结果是排出结石的时间;疼痛发作次数;以及接受手术,入院和出现不良事件患者的比例。研究人员使用随机效应模型计算主要结果的合并风险比和95%置信区间。评估偏倚风险的Cochrane协作工具和GRADE方法用于评价证据的质量和总结结论。

该研究共包括55项随机对照试验。中等质量证据表明α阻滞剂有利于输尿管结石的排出(风险比1.49,95%置信区间1.39至1.61)。基于先验亚组分析,对于较小的输尿管结石患者,使用α阻断剂治疗似乎没有益处(1.19,1.00至1.48)。然而,与对照参与者相比,较大结石的患者使用α阻断剂治疗结石排出风险高57%(1.57,1.17至2.27)。

α阻断剂的作用与结石位置无关(对于上部或中部结石为1.48(1.05至2.10);下部结石为1.49(1.38至1.63))。与对照组相比,接受α受体阻滞剂患者的结石排出时间明显缩短(平均差异-3.79天,-4.45至-3.14;中等质量证据),疼痛发作次数减少(-0.74次,-1.28至-0.21;低质量证据),手术干预风险降低(风险比0.44,0.37至0.52;中等质量证据),住院风险降低(0.37,0.22至0.64;中等质量证据)。治疗组和对照组之间严重不良事件的风险相似(1.49,0.24至9.35;低质量证据)。

α阻滞剂对于对于适合保守治疗的输尿管结石患者的治疗似乎是有效的。结石较大的患者可能受益最大。这些结果支持当前的指南建议倡导α阻断剂在输尿管结石患者中的应用。

原始出处:

John M Hollingsworth,Benjamin K Canales,Mary A M Rogers,et al.Alpha blockers for treatment of ureteric stones. BMJ.01 December 2016.

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2085738, encodeId=1ad12085e38d2, content=<a href='/topic/show?id=723a9e69383' target=_blank style='color:#2F92EE;'>#阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97693, encryptionId=723a9e69383, topicName=阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40be178, createdName=zhyy88, createdTime=Sun Aug 27 05:59:00 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928956, encodeId=c9151928956d0, content=<a href='/topic/show?id=2b1b93e7645' target=_blank style='color:#2F92EE;'>#输尿管结石#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93776, encryptionId=2b1b93e7645, topicName=输尿管结石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 15 11:59:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995136, encodeId=791d1995136c3, content=<a href='/topic/show?id=347538040cf' target=_blank style='color:#2F92EE;'>#受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38040, encryptionId=347538040cf, topicName=受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Fri Jun 02 06:59:00 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640827, encodeId=6606164082e85, content=<a href='/topic/show?id=6ead93e7366' target=_blank style='color:#2F92EE;'>#输尿管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93773, encryptionId=6ead93e7366, topicName=输尿管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9f722746129, createdName=12498bb3m97(暂无昵称), createdTime=Fri Feb 24 13:59:00 CST 2017, time=2017-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042020, encodeId=7bbc20420204c, content=<a href='/topic/show?id=1bce19155b6' target=_blank style='color:#2F92EE;'>#α受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19155, encryptionId=1bce19155b6, topicName=α受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Mon Jun 26 00:59:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848178, encodeId=bdf118481e8d6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 28 19:59:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162167, encodeId=0d4516216e24, content=恩,学习了,临床工作中也一直在用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=65b71729682, createdName=dordu, createdTime=Mon Dec 12 12:14:55 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160374, encodeId=06171603e4d0, content=学习了,好东西,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Dec 05 08:34:14 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160214, encodeId=cdeb160214fa, content=已经用了几年了,针对下段结石效果好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/CE4E757F3E33B5C7BE1F8096EDE2AACA/100, createdBy=f1d11984333, createdName=赖庆权, createdTime=Sun Dec 04 15:41:43 CST 2016, time=2016-12-04, status=1, ipAttribution=)]
    2017-06-28 gaoxiaoe
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    2016-12-12 dordu

    恩,学习了,临床工作中也一直在用!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2085738, encodeId=1ad12085e38d2, content=<a href='/topic/show?id=723a9e69383' target=_blank style='color:#2F92EE;'>#阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97693, encryptionId=723a9e69383, topicName=阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40be178, createdName=zhyy88, createdTime=Sun Aug 27 05:59:00 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928956, encodeId=c9151928956d0, content=<a href='/topic/show?id=2b1b93e7645' target=_blank style='color:#2F92EE;'>#输尿管结石#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93776, encryptionId=2b1b93e7645, topicName=输尿管结石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 15 11:59:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995136, encodeId=791d1995136c3, content=<a href='/topic/show?id=347538040cf' target=_blank style='color:#2F92EE;'>#受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38040, encryptionId=347538040cf, topicName=受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Fri Jun 02 06:59:00 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640827, encodeId=6606164082e85, content=<a href='/topic/show?id=6ead93e7366' target=_blank style='color:#2F92EE;'>#输尿管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93773, encryptionId=6ead93e7366, topicName=输尿管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9f722746129, createdName=12498bb3m97(暂无昵称), createdTime=Fri Feb 24 13:59:00 CST 2017, time=2017-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042020, encodeId=7bbc20420204c, content=<a href='/topic/show?id=1bce19155b6' target=_blank style='color:#2F92EE;'>#α受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19155, encryptionId=1bce19155b6, topicName=α受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Mon Jun 26 00:59:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848178, encodeId=bdf118481e8d6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 28 19:59:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162167, encodeId=0d4516216e24, content=恩,学习了,临床工作中也一直在用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=65b71729682, createdName=dordu, createdTime=Mon Dec 12 12:14:55 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160374, encodeId=06171603e4d0, content=学习了,好东西,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Dec 05 08:34:14 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160214, encodeId=cdeb160214fa, content=已经用了几年了,针对下段结石效果好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/CE4E757F3E33B5C7BE1F8096EDE2AACA/100, createdBy=f1d11984333, createdName=赖庆权, createdTime=Sun Dec 04 15:41:43 CST 2016, time=2016-12-04, status=1, ipAttribution=)]
    2016-12-05 一个字-牛

    学习了,好东西,谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2085738, encodeId=1ad12085e38d2, content=<a href='/topic/show?id=723a9e69383' target=_blank style='color:#2F92EE;'>#阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97693, encryptionId=723a9e69383, topicName=阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40be178, createdName=zhyy88, createdTime=Sun Aug 27 05:59:00 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928956, encodeId=c9151928956d0, content=<a href='/topic/show?id=2b1b93e7645' target=_blank style='color:#2F92EE;'>#输尿管结石#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93776, encryptionId=2b1b93e7645, topicName=输尿管结石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 15 11:59:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995136, encodeId=791d1995136c3, content=<a href='/topic/show?id=347538040cf' target=_blank style='color:#2F92EE;'>#受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38040, encryptionId=347538040cf, topicName=受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Fri Jun 02 06:59:00 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640827, encodeId=6606164082e85, content=<a href='/topic/show?id=6ead93e7366' target=_blank style='color:#2F92EE;'>#输尿管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93773, encryptionId=6ead93e7366, topicName=输尿管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9f722746129, createdName=12498bb3m97(暂无昵称), createdTime=Fri Feb 24 13:59:00 CST 2017, time=2017-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042020, encodeId=7bbc20420204c, content=<a href='/topic/show?id=1bce19155b6' target=_blank style='color:#2F92EE;'>#α受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19155, encryptionId=1bce19155b6, topicName=α受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Mon Jun 26 00:59:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848178, encodeId=bdf118481e8d6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 28 19:59:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162167, encodeId=0d4516216e24, content=恩,学习了,临床工作中也一直在用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=65b71729682, createdName=dordu, createdTime=Mon Dec 12 12:14:55 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160374, encodeId=06171603e4d0, content=学习了,好东西,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Dec 05 08:34:14 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160214, encodeId=cdeb160214fa, content=已经用了几年了,针对下段结石效果好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/CE4E757F3E33B5C7BE1F8096EDE2AACA/100, createdBy=f1d11984333, createdName=赖庆权, createdTime=Sun Dec 04 15:41:43 CST 2016, time=2016-12-04, status=1, ipAttribution=)]
    2016-12-04 赖庆权

    已经用了几年了,针对下段结石效果好

    0