Department of Urology, McGill University, Montreal, Quebec, Canada.
Neurourol Urodyn. 2012 Sep;31(7):1197-202. doi: 10.1002/nau.21214. Epub 2012 Mar 30.
To assess the effects of different doses and treatment durations of pregabalin and lamotrigine on the urodynamic parameters of an animal model of neurogenic detrusor overactivity (NDO).
Ninety rats were used; six as normal controls and the remaining 84 were divided as follows: Six "paraplegic controls," 6 "paraplegic-vehicle controls," and the remaining 72 divided into two equal groups. Group 1 was divided into six subgroups; pregabalin was given in doses of 10 mg/kg, 20 mg/kg, or 30 mg/kg for 1 or 2 weeks. Group 2 was similarly subdivided; lamotrigine was given in doses of 1.5 mg/kg, 3 mg/kg, or 6 mg/kg for 1 or 2 weeks.
All paraplegic controls developed NDO within 3 weeks from spinalization. Their baseline bladder pressure (BBP) 19 ± 4.4 cmH(2) O, detrusor pressure at maximum capacity (DPMaxC) 47.6 ± 4.3 cmH(2) O, bladder capacity (BC) 0.45 ± 0.1 ml, and frequency of detrusor overactivity (FDO) 3.7 ± 0.9/min. Both pregabalin and lamotrigine produced significant improvement. Urodynamic values in those treated with 20 mg pregabalin for 1 or 2 weeks were: BBP 11.7 ± 1.3 and 9 ± 0.2 cmH(2) O, BC 0.6 ± 0.1 and 0.7 ± 0.01 ml, DPMaxC 17.3 ± 4.0 and 23 ± 2.6 cmH(2) O, FDO 2.1 ± 0.2/min and 1.7 ± 0.1/min. Urodynamic values in those treated with 3 mg/kg lamotrigine for 1 or 2 weeks were: BBP 9.7 ± 2.2 and 8.6 ± 1.9 cmH(2) O, DPMaxC 17.2 ± 1.8 and 29 ± 1.2 cmH(2) O, BC 0.7 ± 0.1 and 0.8 ± 0.1 ml, FDO 1.9 ± 0.2/min and 1.9 ± 0.2/min (P < 0.001).
Pregabalin and lamotrigine may represent novel alternative treatments of NDO. Clinical trials remain to be performed.
评估不同剂量和治疗持续时间的普瑞巴林和拉莫三嗪对神经原性逼尿肌过度活动(NDO)动物模型尿动力学参数的影响。
使用 90 只大鼠;6 只为正常对照组,其余 84 只分为以下六组:6 只为截瘫对照组,6 只为截瘫对照组,其余 72 只分为两组。第 1 组分为 6 个亚组;给予 10mg/kg、20mg/kg 或 30mg/kg 普瑞巴林治疗 1 或 2 周。第 2 组也进行了细分;给予 1.5mg/kg、3mg/kg 或 6mg/kg 的拉莫三嗪治疗 1 或 2 周。
所有截瘫对照组在脊髓化后 3 周内均出现 NDO。他们的基线膀胱压(BBP)为 19 ± 4.4cmH2O,最大容量时逼尿肌压(DPMaxC)为 47.6 ± 4.3cmH2O,膀胱容量(BC)为 0.45 ± 0.1ml,逼尿肌过度活动频率(FDO)为 3.7 ± 0.9/min。普瑞巴林和拉莫三嗪均有显著改善。接受 20mg/kg 普瑞巴林治疗 1 或 2 周的患者的尿动力学值为:BBP 11.7 ± 1.3 和 9 ± 0.2cmH2O,BC 0.6 ± 0.1 和 0.7 ± 0.01ml,DPMaxC 17.3 ± 4.0 和 23 ± 2.6cmH2O,FDO 2.1 ± 0.2/min 和 1.7 ± 0.1/min。接受 3mg/kg 拉莫三嗪治疗 1 或 2 周的患者的尿动力学值为:BBP 9.7 ± 2.2 和 8.6 ± 1.9cmH2O,DPMaxC 17.2 ± 1.8 和 29 ± 1.2cmH2O,BC 0.7 ± 0.1 和 0.8 ± 0.1ml,FDO 1.9 ± 0.2/min 和 1.9 ± 0.2/min(P < 0.001)。
普瑞巴林和拉莫三嗪可能是治疗 NDO 的新的替代疗法。仍需进行临床试验。