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首页> 美国卫生研究院文献>Therapeutic Advances in Drug Safety >Risk of acute urinary retention associated with inhaled anticholinergics in patients with chronic obstructive lung disease: systematic review
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Risk of acute urinary retention associated with inhaled anticholinergics in patients with chronic obstructive lung disease: systematic review

机译：慢性阻塞性肺疾病患者吸入抗胆碱药与急性尿retention留的风险：系统评价

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Inhaled anticholinergics (ipratropium bromide and tiotropium bromide) are widely used as maintenance treatment in chronic obstructive pulmonary disease. Previous studies have reported on their cardiovascular effects but relatively little is known about their effects on the bladder. Acute urinary retention is a medical emergency which can be associated with serious complications. Our objective was to evaluate the existing literature regarding the effects of inhaled anticholinergics on urinary retention among patients with chronic obstructive pulmonary disease. We searched PubMed and the United States Food and Drug Administration (FDA) adverse events database for case reports, observational studies, randomized controlled trials (or meta-analyses of such trials) that reported on the outcome of urinary retention with inhaled anticholinergics (ipratropium or tiotropium). We checked 27 published articles and identified relevant papers including two case reports, three pooled analyses, two observational studies and one randomized controlled trial. Two of the observational studies and a pooled analysis of randomized controlled trials reported a significant increase in the risk of acute urinary retention with inhaled anticholinergics. Older patients with benign prostatic hyperplasia seem to be at the highest risk of this adverse effect which tends to occur soon after treatment initiation. Although all the links in the chain have yet to be fully elucidated, the preponderance of evidence suggests the possibility of a causal relationship between inhaled anticholinergics and urinary retention. Clinicians should carefully balance these and other adverse effects of inhaled anticholinergics against their known symptomatic benefits on exacerbations, after eliciting patient preferences for various outcomes in a shared decision-making context.
机译：吸入性抗胆碱能药（异丙托溴铵和噻托溴铵）被广泛用作慢性阻塞性肺疾病的维持治疗。先前的研究已经报道了它们对心血管的影响，但是对它们对膀胱的影响知之甚少。急性尿retention留是一种医疗急症，可能伴有严重的并发症。我们的目的是评估关于吸入性抗胆碱药对慢性阻塞性肺疾病患者尿retention留的影响的现有文献。我们在PubMed和美国食品药品监督管理局（FDA）不良事件数据库中进行了搜索，以了解病例报告，观察性研究，随机对照试验（或此类试验的荟萃分析），这些研究报告了吸入性抗胆碱能药物（异丙托品或噻托溴铵）。我们检查了27篇发表的文章并确定了相关论文，包括2例病例报告，3项汇总分析，2项观察性研究和1项随机对照试验。两项观察性研究和一项随机对照试验的汇总分析表明，吸入抗胆碱能药可导致急性尿retention留的风险显着增加。患有良性前列腺增生的老年患者似乎最有可能在治疗开始后立即发生这种不良反应。尽管该链中的所有环节尚未完全阐明，但大量证据表明，吸入的抗胆碱能药与尿retention留之间可能存在因果关系。在共同决策的情况下引起患者对各种结局的偏爱后，临床医生应仔细权衡吸入式抗胆碱能药的这些及其他不利影响与已知的症状加重之间的关系。

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