2008-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644677背景/目標:膀胱過動症(OAB)大約影響17%的婦女。但是OAB 之致病機轉至今仍複雜不 清，尤其關於OAB 患者精神方面致病因素的研究很少。另外，目前文獻上影響OAB 藥物 治療(tolterodine)之因子及tolterodine 於OAB 患者心臟血管安全性之研究亦無。因 此本研究目標為(1)分析OAB 患者精神方面之可能致病因子。(2)分析精神方面及尿動力 診斷方面影響治療效果的預後因子。(3)分析tolterodine 對於OAB 病人心臟傳導及心 律變異之影響。(4)分析non-OAB 與OAB 患者動脈硬度之差異，及tolterodine 對OAB 患者動脈硬度之影響。 病人及方法:預計於三年內於台大醫院婦產科收集130 個OAB 案例分析服用十二週 tolterodine 藥物前後之下列變化包括:中文版OAB-q 問卷、中文版UDI-6 & IIQ-7 問卷、 精神科簡式症狀表、簡式性格量表、家庭關懷量表、標準12-leads 心電圖、二十分鐘 Holter 監測、cardio-ankle vascular index 測量、排尿日記、二十分鐘護墊試驗和尿 路動力學檢查。同時找年齡層相仿130 例non-OAB 對照組案例進行對照分析。 預期成果: (1)得到OAB 精神方面可能致病因子。(2)藉由服藥後改善者與未改善者之分 析得到影響療效的精神及尿動力診斷方面預後因子。(3)得到tolterodine 對於OAB 病 人心臟傳導及心律變異之影響，進而得到藥物安全性評估和對自主神經系統影響。(4) 得到OAB 患者與non-OAB 患者動脈硬度之比較。也可得到tolterodine 對動脈硬度之影 響，進而推估對心血管疾病之影響Background/Purpose: The overactive bladder syndrome (OAB) affects around 17 % of female population. However, the etiology of OAB was complicated and unclear in many aspects. In particular, the research about psychiatric aspect of etiology in OAB was paucity. Besides, research about prognostic factors and impact of cardiovascular system of OAB treatment was also paucity. Therefore the aims of our study were (1) to analyze the etiology of OAB in psychiatric aspects; (2) to analyze the prognostic factors associated with tolterodine treatment; (3) to analyze the differences of cardiac conduction and heart rate variability before and after tolterodine treatment; (4) to analyze the differences of arterial stiffness between non-OAB and OAB female patients, and before and after tolterodine treatment. Patients and Methods: We will perform a prospective study to recruit 130 female OAB patients at the outpatient clinic of Department of Obstetrics and Gynecology of National Taiwan University Hospital. All OAB female patients will be asked to complete OAB-q, UDI-6&IIQ-7, brief symptom rating scale (BSRS), Maudsley personality inventory (MPI) and adaptability, partnership, growth, affection, and resolve (APGAR) questionnaires, standard 12-leads electrocardiography (ECG), 20 minutes Holter monitoring, cardio-ankle vascular index (CAVI) test, voiding diary, 20-min pad test and urodynamic studies before and after 12 weeks’ tolterodine treatment. Besides, we will also recruit 130 non-OAB female patients in our outpatient clinic, and they will be asked to complete the above questionnaires and examinations except pad test and urodynamic studies. The above parameters will be compared between non-OAB and OAB subjects, and also before and after treatment. STATA software was used for statistical analyses. Possible Results: With the comparison of the above parameters between non-OAB and OAB patients, and also before and after treatment, we can answer the questions that (1) the role of psychiatric aspects in OAB; (2) the psychiatric and urodynamic factors that affect outcome of tolterodine treatment; (3) the differences of cardiac conduction and heart rate variability before and after tolterodine treatment; (4) the differences of arterial stiffness between non-OAB and OAB female patients, and before and after tolterodine treatment.膀胱過動症抗毒蕈鹼藥物尿路動力學檢查overactive bladder syndromeantimuscarinic drugurodynamic studies