目的：探讨α-硫辛酸联合甲钴胺对糖尿病神经源性膀胱尿流动力学及血清超氧化物歧化酶（ SOD）的影响。方法选择2014年6月—2015年6月武汉市普仁江岸医院和武汉大学人民医院急诊科收治糖尿病神经源性膀胱患者70例，随机分为观察组和对照组，每组35例。对照组患者给予甲钴胺治疗，观察者患者给予α-硫辛酸联合甲钴胺治疗，对2组患者治疗前后的尿流动力学指标、膀胱残余尿量及SOD水平进行比较。结果（1）与治疗前比较，2组患者最大尿流率（ MFR）、最大尿流率时逼尿肌压力（ PQmax）、膀胱最大测压容量（ VMBC）均明显改善（ P ＜0构．05），且观察组改善优于对照组（ P ＜0．05）。（2）与治疗前比较，2组患者治疗后的膀胱顺应性（BC）明显升高（P ＜0．05），观察组患者功能性尿道长度（LSF）、最大尿道压（PMU）及对照组的PMU均明显降低（ P ＜0．05），且观察组BC、LSF、PMU改善优于对照组（ P ＜0．05）。（3）治疗后2组患者的膀胱残余尿量明显低于治疗前（ P ＜0．05），且观察组降低较对照组更明显（ P ＜0．05）。（4）与治疗前比较，治疗后对照组SOD水平无显著变化（ P ＞0．05），观察组患者血清SOD水平明显升高（ P ＜0．05），且观察组明显高于对照组（ P ＜0．05）。结论α-硫辛酸联合甲钴胺治疗糖尿病神经源性膀胱，可明显改善尿流动力学指标和膀胱残余尿量，提高抗氧化应激能力。%Objective To investigate the alpha lipoic acid combined with mecobalamin on diabetic neurogenic blad-der urine flow dynamics and serum superoxide dismutase (SOD).Methods From June 2015 to June 2014, 70 cases of dia-betic neurogenic bladder were randomly divided into observation group and control group, 35 cases in each group, they were randomly divided into the observation group and the control group.In the control group,patients were treated with Mecobal-amin, observation group patients treated with alpha lipoic acid combined with mecobalamin , before and after the treatment, the patients in the two groups’ urine flow dynamic indexes, bladder residual urine and SOD level were compared .Rseults (1) Compared with that before treatment, 2 groups of patients’ maximal urinary flow rate (MFR), maximum urinary flow rate when the detrusor pressure ( PQmax ) , urinary bladder maximum piezometric capacity VMBC were significantly improved (P <0.05), and observation group was better than the control group ( P <0.05).(2) Compared with that before treat-ment, after treatment, the patients in the two groups’ bladder compliance (BC) increased significantly ( P <0.05), obser-vation group’ s functional urethral length ( LSF) , maximum urethral pressure ( PMU) and the control group’ s PMU decreased significantly ( P <0.05), and the observation group’ s BC,LSF, PMU was better than that of the control group ( P <0.05).(3) The residual urine volume in the 2 groups of patients after treatment were significantly lower than before treat -ment,the difference was statistically significant ( P <0.05) , and the observation group decreased more significantly ( P <0.05).(4) Compared with that before treatment, after treatment, the control group’s level of SOD had no significant change ( P >0.05), observation group patients’ serum SOD level significantly increased ( P <0.05), and the observation group was significantly higher than that of the control group, the difference was statistically significant ( P <0.05).Conclusion Alpha lipoic acid combined with mecobalamin in treatment of diabetic neurogenic bladder can significantly improve urine flow dynamic indexes and the bladder residual urine volume and improving the ability of antioxidative stress , which is worthy of clinical popularization and application.
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