代谢综合征与良性前列腺增生的相关性研究

目的 探讨代谢综合征(MS)与良性前列腺增生症(BPH)发生发展的相关性.方法 纳入2008年9月至2010年1月于北京大学人民医院老年科住院的男性MS患者101例;同时纳入同期的非MS男性患者117例.测量血压、身高、体质量、计算体质指数(BMI),并检测空腹血糖( FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和前列腺特异性抗原(PSA),超声测量及计算前列腺体积(PV).结果 MS组患者PV为(39.7±21.1)ml明显大于非MS患者的(30.7±9.3)ml(P＜0.05).PSA两组比较差异无统计学意义(P＞0.05).PV与BMI(r= 0.37,P=0.001)、高血压病程(r=0.27,P=0.019)、PSA(r=0.51,P=0.001)、FBG(r=0.24,P=0.013)、收缩压(r=0.20,P=0.047)呈正相关(P＜0.05),与HDL-C呈负相关(r=-0.24,P=0.013).结论 BMI,高血压病程,PSA,FBG,收缩压和低HDL-C水平可能是BPH发生发展的危险因素.     

2型糖尿病与良性前列腺增生症的相关性研究

目的 探讨2型糖尿病(T2DM)与良性前列腺增生症(BPH)发生与进展的相关性.方法 随机选择男性T2DM患者177例和男性正常对照组225例.测量血压、身高、体重,计算体重指数(BMI).并检测空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和前列腺特异性抗原(PSA)水平.采用经腹部超声测量前列腺体积.结果 ①与正常对照组相比,T2DM组的BMI、收缩压、FPG、TG、TC、LDL-C、前列腺体积和PSA水平显著升高,但HDL-C水平较低(P<0.01).②T2DM组前列腺体积增大的发生率明显高于正常对照组,有极显著性差异(P＜0.001).③前列腺体积与FPG(r=0.189,P<0.05)和血清PSA水平呈正相关(r=0.270,P<0.001),与舒张压(r=-0.151,P<0.05)、TC(r=-0.186,P<0.05)、LDL-C(r=-0.208,P<0.01)呈负相关.结论 T2DM是BPH发生与进展的危险因素.     

杓型与非杓型老年高血压病人心脏结构、功能评估及与踝臂指数关系

目的评估杓型与非杓型老年高血压病人心脏结构、功能是否存在差异,并探讨踝臂指数(ABI)在评估左心室结构、功能的效能上是否因杓型与非杓型而出现偏差。方法选取2016年1月至2019年9月期间在我院就诊的236例原发性高血压病人按杓型高血压组及非杓型高血压分为2组,每组118例,并进一步分为2个亚组,ABI0.9定义为正常ABI亚组,ABI≤0.9定义为低ABI亚组。观察并比较2组左心室结构、功能及与ABI的相关性。结果非杓型高血压组舒张末期室间隔厚度(IVSD)、左心室舒张末期后壁厚度(LVPWD)、左心室重量指数(LVMI)均高于杓型高血压组(P0.05);而LVEF、峰值舒张早期速度(E)/峰值晚期舒张速度(A)及ABI均低于杓型高血压组(P0.05)。杓型高血压组中,低ABI病人IVSD、LVMI高于正常ABI病人(P0.05);而LVEF低于正常ABI病人(P0.05);非杓型高血压组中,低ABI组病人IVSD、LVPWD、LVMI高于正常ABI组病人(P0.05);而LVEF、E/A低于正常ABI组病人(P0.05)。相关性分析显示,杓型高血压组病人ABI与IVSD、LVMI呈负相关(r=-0.601、-0.391);与LVEF呈正相关(r=0.449)。非杓型高血压组ABI与IVSD、LVPWD、LVMI呈负相关(r=-0.518、-0.397、-0.224);与LVEF、E/A呈正相关(r=0.516、0.216)。结论非杓型老年高血压病人左心室肥厚及功能受损更为严重。在评估原发性高血压的左心室结构、功能上,非杓型高血压病人左心功能与ABI关系更为密切。因此,在临床运用ABI时,建议对老年高血压病人血压模式进行分型,有助于提高ABI的评估效能。     

老年高血压患者血压昼夜节律与炎症因子、尿微量白蛋白的相关性

目的探讨老年高血压患者血压昼夜节律变化与超敏C反应蛋白(hs-CRP)、尿微量蛋白(MAU)的相关关系。方法将76例老年高血压患者按照24 h动态血压(24 h ABPM)结果分为A、B组,A组为杓型组,共31例;B组为非杓型组,共35例,分别检测hs-CRP、MAU。结果 B组的hs-CRP水平明显高于A组(P<0.01);B组的MAU水平明显高于A组(P<0.01);非杓型组夜间收缩压(nSBP)与hs-CRP、MAU之间存在正相关(r=0.426,P<0.01;r=0.285,P<0.01)。结论老年非杓型高血压患者血压昼夜节律变化与hs-CRP、MAU关系密切。     

替米沙坦联合非那雄胺治疗非杓型高血压合并前列腺增生患者效果观察

目的探讨替米沙坦联合非那雄胺治疗非杓型高血压合并前列腺增生患者临床效果。方法 190例非杓型高血压合并前列腺增生患者随机分组,对照组82例,观察组108例。对照组口服40 mg/d替米沙坦,观察组于对照组基础上加服5mg/d非那雄胺治疗,比较两组24 h平均收缩压(24 hSBP)、平均舒张压(24 hDBP)、平均脉压差(24 hPP);日间平均收缩压(dSBP)、平均舒张压(dDBP)、平均脉压差(dPP);夜间平均收缩压(nSBP)、平均舒张压(nDBP)、平均脉压差(nPP)及治疗前后前列腺体积、夜尿次数。结果治疗后3、6个月观察组24 hSBP、24 hDBP、24 hPP、dSBP、dDBP、dPP、nSBP、nDBP及nPP水平均低于对照组(P0.05);夜尿次数及前列腺体积均小于对照组(P0.05)。结论对非杓型高血压合并前列腺增生患者给予非那雄胺联合替米沙坦治疗效果显著,可有效缩小患者前列腺体积,减少夜尿次数,改善血压水平。     

代谢综合征与前列腺体积的相关性

目的 探讨代谢综合征(metabolic syndrome,MS)与前列腺体积的相关性. 方法 选择年龄36～90岁男性1098人,采用2004年中华医学会糖尿病学分会提出的MS建议诊断标准.分为MS组和对照组.测量血压、身高、体质量,计算体质指数(BMI).生化分析包括血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDI-C)、高密度脂蛋白胆固醇(HDL-C)和前列腺特异性抗原(PSA).采用经腹部超声测量前列腺体积. 结果 (1)与对照组比较.MS组的BMI、收缩压、舒张压、空腹血糖、三酰甘油、总胆固醇、前列腺体积和PSA水平较高,但HDL-C水平较低(均P<0.05);(2)MS组前列腺体积较对照组增大,分别为(31.0±11.1)ml和(37.8±21.3)ml,两组差异有统计学意义(P<0.01);(3)前列腺体积与血清PSA水平(r=0.350,P<0.01)、年龄(r=0.429,P<0.01)、BMl(r=0.145,P<0.01)、收缩压(r=0.133,P<0.05)呈正相关,与舒张压(r=0.193,P<0.01)呈负相关. 结论 MS与前列腺体积增大有关.     

原发性高血压患者血压昼夜节律及夜间血压与阵发性心房颤动的相关性

目的探讨原发性高血压患者血压昼夜节律及夜间血压与阵发性心房颤动(房颤)的相关性,并探讨其他危险因素对阵发性房颤的影响。方法选择原发性高血压患者411例,其中阵发性房颤组159例,窦性心律组252例,所有患者采集病史、体格检查、行动态血压、常规生化等检查。结果阵发性房颤组非杓型血压比例(96.2%vs83.7%)、夜间收缩压[(132.23±16.50)mm Hg vs(122.38±17.70)mm Hg,1 mm Hg=0.133kPa]、夜间脉压[(62.74±16.67)mm Hg vs(50.83±14.52)mm Hg]明显高于窦性心律组(P<0.01)。单因素相关分析显示,非杓型血压(r=0.191,P<0.01)、夜间收缩压(r=0.254,P<0.01)、夜间脉压(r=0.353,P<0.01)与阵发性房颤呈正相关;调整年龄、血脂、餐后2h血糖、24h血压、昼间血压等危险因素后,二分类logistic回归分析显示,非杓型血压、夜间收缩压升高、年龄是阵发性房颤的独立危险因素。结论非杓型血压、夜间收缩压升高是原发性高血压患者阵发性房颤的独立危险因素,与阵发性房颤发生密切相关。     

高血压患者颈动脉内膜中膜厚度与动态血压参数的关系

目的探讨高血压患者颈动脉内膜中膜厚度(IMT)与动态血压参数的关系。方法选择2014年7月至2015年12月石河子大学医学院第一附属医院收治的高血压患者94例,根据颈动脉超声结果分为单一斑块组和多发斑块组,同时根据超声中IMT的数值,将患者分为IMT正常组和IMT增厚组,另外根据动态血压监测(ABPM)检查结果分为杓型组和非杓型组。应用彩色超声心动图仪测量IMT值,并采用动态血压监测仪对患者进行24 h ABPM检测,记录各项动态血压参数。对比分析不同分组IMT值和动态血压参数及IMT值与动态血压参数的相关性。结果与单一斑块组相比,多发斑块组动态血压参数和IMT水平明显升高(P<0.05);杓型组明显低于非杓型组(P<0.05);IMT增厚组各动态血压参数明显高于IMT正常组(P<0.05);颈动脉IMT值与24 h平均收缩压(SBP)、24 h平均舒张压(DBP)、白昼SBP(d SBP)、夜间SBP(n SBP)、d DBP、n DBP及24 h平均脉压(PP)呈正相关(r=0.723、0.694、0.731、0.689、0.703、0.711、0.756,P=0.028、0.038、0.025、0.040、0.035、0.032、0.018)。结论老年高血压患者中多发性斑块及非杓型均是造成动态血压参数和IMT数值升高的原因;同时,IMT增厚也是诱发动态血压参数升高的原因,且两者之间存在良好的正相关,为临床上治疗老年高血压患者提供新的思路。     

高龄男性原发性高血压患者血压昼夜节律与动脉硬化程度的关系初探

目的探讨高龄男性原发性高血压患者血压昼夜节律与动脉硬化的关系。方法选择2019年1～12月南部战区总医院干部病房四科收治的高龄男性原发性高血压患者160例,年龄80～98岁。行24 h动态血压检测,根据血压昼夜节律分为超杓型组(夜间/昼间血压比值≤0.8)6例,杓型组(0.8夜间/昼间血压比值≤0.9)24例,非杓型组(0.9夜间/昼间血压比值≤1)83例,反杓型组(夜间/昼间血压比值1)47例。行颈动脉超声检测,计算心踝指数、踝肱指数、每搏外周阻力和每搏外周阻力指数,比较各组一般临床资料及心踝指数、踝肱指数、每搏外周阻力、每搏外周阻力指数的差异。比较夜间/昼间血压与心踝指数、踝肱指数、每搏外周阻力、每搏外周阻力指数的相关性。结果各组颈动脉硬化积分、心踝指数、踝肱指数比较,差异有统计学意义(P0.01)。各组每搏外周阻力、每搏外周阻力指数比较,差异无统计学意义(P0.05)。夜间舒张压/昼间舒张压比值与颈动脉硬化积分、心踝指数、踝肱指数呈正相关(r=0.490,P=0.000;r=0.617,P=0.000;r=0.776,P=0.000);而夜间收缩压/昼间收缩压比值与心踝指数、踝肱指数呈正相关(r=0.247,P=0.002;r=0.208,P=0.010)。结论高龄男性原发性高血压患者夜间舒张压/昼间舒张压比值与动脉僵硬度显著相关;夜间收缩压/昼间收缩压比值与动脉僵硬度相关性较小。改善动脉僵硬程度可能有利于血压昼夜节律的恢复。     

动态血压与颈动脉粥样硬化及左室肥厚的关系

目的 探讨原发性高血压(EH)患者动态血压参数异常与颈动脉粥样硬化(CAS)及左室肥厚(LVH)之间的关系.方法 对EH患者321例进行24 h动态血压监测,并按动态血压监测结果分为非杓型组(n=223)与杓型组(n=98);同时采用彩色多普勒超声诊断仪测量患者颈动脉内膜中膜厚度(IMT)和左室质量指数(LVMI).结果 1)非杓型组夜间血压较杓型组升高(P<0.01).2)非杓型组cAs的检出率(61.4%)较杓型组(49.0%)增加(χ2=4.33,P<0.05),非杓型组LVH检出率(38.1%)较杓型组(20.4%)增加(χ2=9.70,P<0.01);3)CAS组24 h动态脉压值较颈动脉IMT正常组升高(P<0.01).结论 EH患者动态血压参数异常与CAS和LVH相关.     

代谢综合征对老年人良性前列腺增生病程的影响

目的 探讨代谢综合征(MS)在老年人良性前列腺增生(BPH)病程中的作用.方法 101例BPH患者分为单纯BPH组45例与合并MS的BPH组56例,分析体质量指数(BMI)、腰围、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBS)、胰岛素抵抗指数(HOMA-IR)等代谢性因素对BPH患者前列腺体积(PV)、血清前列腺特异性抗原(PSA)、国际前列腺症状评分(IPSS)、下尿路症状(LUTS)出现时间的影响.结果 合并MS的BPH患者PV明显大于单纯BPH患者(t=3.22,P=0.003),LUTS出现时间长于后者(t=2.02,P=0.046).超重和肥胖的BPH患者PV明显大于正常体质量组[分别为(49.44±26.83)ml与(38.10±10.64)ml,P=0.021;(51.7±22.2)ml与(38.10±10.64)ml,P=0.043];腹型肥胖的BPH组患者PV明显大于非腹型肥胖的BPH患者组[(50.26±26.51)ml与(38.99±11.25)ml,P=0.005].低HDL-C水平组PV明显大于正常HDL-C水平组[(54.23±28.92)ml与(40.40±14.87) ml,P=0.009].FBS水平异常的BPH患者PV、PSA水平超过正常FBS水平者(t=3.17,2.41; P=0.035,0.013).合并胰岛素抵抗的BPH患者的PV明显大于胰岛素敏感者(t=3.43,P=0.001),LUTS出现时间在胰岛素抵抗组明显延长(t=3.58,P=0.001).PV与BMI (r=0.46,P=0.000)、FINS (r=0.42,P=0.001)、HOMA-IR (r=0.49,P=0.003)呈正相关;而与HDL-C(r=-0.38,P=0.000)呈负相关.多元逐步回归分析显示PV与HOMA-IR关系最密切.结论 MS对BPH的病程和发展具有明显的影响.     

Effect of GH and/or testosterone deficiency on the prostate: an ultrasonographic and endocrine study in GH-deficient adult patients

BACKGROUND: The role of IGF-I in prostate development is currently under thorough investigation since it has been claimed that IGF-I is a positive predictor of prostate cancer. OBJECTIVE: To investigate the effect of chronic GH and IGF-I deficiency alone or associated with testosterone deficiency on prostate pathophysiology in a series of patients with hypopituitarism. DESIGN: Pituitary, androgen and prostate hormonal assessments and transrectal prostate ultrasonography (TRUS) were performed in 30 men with adulthood onset GH deficiency (GHD) and 30 age-matched healthy controls, free from previous or concomitant prostate disorders. RESULTS: Plasma IGF-I levels were significantly lower in GHD patients than in controls (Pearson's coefficient P<0.0001). At study entry, 6 of the 13 hypogonadal patients and 7 of the 17 eugonadal patients had plasma IGF-I below the age-adjusted normal range. At study entry, testosterone levels were low in 13 patients (mean +/-s.e.m., 3.8+/-1.0 nmol/l) while they were normal in the remaining 17 (19.4+/-1.4 nmol/l). No difference in prostate-specific antigen (PSA), and PSA density was found between GHD patients (either hypo- or eugonadal) and controls, while free PSA levels were significantly higher in eugonadal GHD than in controls (0.4+/-0.04 vs 0.2+/-0.03 microg/l; P<0.01). No difference in antero-posterior prostate diameter and transitional zone volume (TZV) was observed among groups, while both transverse and cranio-caudal diameters were significantly lower in hypogonadal (P<0.01) and eugonadal GHD patients (P<0.05) than in controls. Prostate volume (PV) was significantly lower in hypogonadal GHD patients (18.2+/-3.0 ml) and eugonadal GHD patients (22.3+/-1.6 ml), than in controls (25.7+/-1.4, P<0.05). The prevalence of prostate hyperplasia (PV>30 ml) was significantly lower in hypogonadal and eugonadal GHD patients, without any difference between them (15.3% and 5.8%), than in controls (43.3%) (chi(2)=6.90, P=0.005). No difference was found in PV between patients with normal or deficient IGF-I levels both in the hypogonadal group (19. 9+/-4.7 vs 17.3+/-4.0 ml) and in the eugonadal group (22.6+/-2.3 vs 21.8+/-2.5 ml). When controls and patients were divided according to age (<60 years and >60 years), PV was significantly lower in hypogonadal GHD patients aged below 60 years than in age-matched controls (P<0.01) or eugonadal GHD patients (P<0.01), without any difference between controls and eugonadal GHD patients. Controls aged above 60 years had significantly higher PV than both hypogonadal and eugonadal GHD patients (P<0.01). Calcifications, cysts or nodules were found in 56.7% of patients and in 50% of controls (chi(2)=0.067, P=0.79). In controls, but not in GHD patients, PV and TZV were correlated with age (r=0.82, r=0.46, P<0. 0001 and P<0.01 respectively). PV was also correlated with GH (r=-0. 52, P=0.0026), IGF-I (r=-0.62, P=0.0002) and IGF-binding protein 3 (IGFBP-3) levels (r=-0.39, P=0.032) but neither with testosterone or dihydrotestosterone (DHT) levels. In GHD patients TZV but not PV was correlated with age (r=0.58, P=0.0007) and neither TZV nor PV were correlated with GH, IGF-I or IGFBP-3 levels. CONCLUSIONS: Chronic GH deficiency in adulthood causes a decrease in prostate size, mostly in patients with concomitant androgen deficiency and age below 60 years, without significant changes in the prevalence of structural prostate abnormalities.     

老年人良性前列腺增生症与胰岛素抵抗

目的 观察胰岛素抵抗和空腹胰岛素(FINS)水平与老年良性前列腺增生(BPH)的关系. 方法 以2008年2月在湘雅二医院老年病科门诊就诊的BPH患者68例为观察对象,分析FINS、血清前列腺特异性抗原(PSA)、糖化血红蛋白、空腹血糖、餐后2 h血糖,计算胰岛素抵抗指数(HOMA-IR).测量血压、体质量、身高、腹围,计算体质指数.测定前列腺体积,评估下尿路症状(LUTS),并询问LUTS出现的时间. 结果 (1)按照HOMA-IR＞2.8为胰岛素抵抗,将患者分为敏感组48例和抗组20例,结果显示抵抗组患者的前列腺体积高于敏感组,分别为(61.1±32.9)ml和(40.4±16.5)ml,差异有统计学意义(P＜0.05);两组PSA分别为(3.3±2.3)μg/L与(2.9±1.3)μg/L,差异无统计学意义(P＞0.05);LUTS出现时间(13.4±6.6)年和(8.7±6.0)年,差异无统计学意义(P＞0.05);国际前列腺症状评分(IPSS)分别为(16.4±6.7)分和(13.3±7.1)分,差异无统计学意义(P＞0.05).(2)以前列腺症状药物治疗(MTOPS)研究的进展性评价指标为标准,将患者分为低进展组与高进展组,分别为30例和38例,两组FINS、HOMA-IR比较,差异有统计学意义(均P＜0.01).(3)前列腺体积与HOMA-IR、FINS呈正相关(r值分别为0.431和0.492,均P＜0.01).结论老年BPH患者存在胰岛素抵抗,胰岛素抵抗程度、高FINS水平与前列腺体积的增大及疾病进展有关.     

老年原发性高血压患者动态血压参数与前列腺体积的相关性

目的 探讨老年原发性高血压患者动态血压参数与前列腺体积的相关性. 方法 选择2007年3月至2009年12月在我科就诊的老年男性原发性高血压患者131例,其中良性前列腺增生(BPH)组102例,非BPH组(NBPH)29例,所有患者均进行动态血压监测及前列腺超声检查,计算前列腺体积;应用SSPS13.0软件包进行统计分析,对两组前列腺体积进行均数检验,应用Spearman回归系数法对所有患者的动态血压参数与前列腺体积进行相关性检验. 结果 (1)BPH组的夜间最大平均动脉压(MAP)(104.7±12.0)mm Hg,高于NBPH组(99.6±10.1)mm Hg,差异有统计学意义(t=2.088,P=0.039);(2)动态血压参数中全天最大MAP(r=0.184,P=0.035)、白天最大MAP(r=0.183,P=0.037)、夜间最大MAP(r=0.181,P=0.040)与前列体积具有相关性.结论老年原发性高血压患者动态血压参数中的最大MAP与前列腺体积具有相关性.     

老年人良性前列腺增生与心血管疾病的关系

目的 了解老年良性前列腺增生(BPH)患者临床特点及用药情况,探讨BPH与心血管疾病的关系. 方法 搜集本院老年病科100例BPH患者临床资料,采用国际前列腺症状评分表(IPSS)、生活质量量表(QOL)对患者进行评价,所有患者均详细询问心血管病史,并检测前列腺特异性抗原(PSA)水平,采用腹部超声测量前列腺体积(PV). 结果 老年BPH患者PV和PSA随年龄增长而升高;疾病严重程度以中度(IPSS 8～19分)多见;BPH患者高血压、冠心病和糖尿病患病率高,冠心病者PV显著高于非冠心病者(P＜0.05);我院BPH患者服用5-α还原酶抑制剂和α-受体阻滞剂者多见,治疗依从性好. 结论 老年BPH患者严重程度与年龄、冠心病发病相关;药物干预治疗以5-α还原酶抑制剂使用率最高.     

Insulin-like growth factor-binding protein-2 in patients with prostate carcinoma and benign prostatic hyperplasia

OBJECTIVE Insulin-like growth factor-binding protein (IGFBP)-2 is a major prostatic IGFBP and may be involved in regulating prostate growth. Patients with prostate carcinoma (PC) have elevated serum IGFBP-2 levels which correlate with the specific PC marker, prostate-specific antigen (PSA). The aims of this study were to investigate whether elevated serum IGFBP-2 is unique to PC or also occurs in benign prostatic hyperplasia (BPH), to examine the relations among age, PSA and IGFBP-2 levels, and to examine longitudinal changes in serum IGFBP-2 with PSA in prostate carcinoma. DESIGN AND PATIENTS Sixteen patients (61–83 years) with inoperable PC attending the oncology unit at a tertiary referral hospital were studied. Some serum samples were obtained retrospectively while the majority were collected prospectively over 13 months of treatment. The patients with PC were compared to 8 patients (66–73 years) with histologically proven BPH and 7 male control subjects (61–82 years) with no known prostate abnormality. MEASUREMENTS A new IGFBP-2 RIA was developed. Serum PSA (by EIA), and IGFBP-2, IGFBP-3, IGF-I and IGF-II (by RIA) were measured in all subjects, and serially in patients with PC. RESULTS Serum IGFBP-2 was significantly higher in PC with high PSA (560 ± 66 μg/l, n = 12) than PC with normal PSA (292 ± 65 μg/l, n = 4, P = 0.02), BPH (364 ± 61 μg/l, P = 0.03) and controls (367 ± 44 μg/l, P = 0.04). Mean IGFBP-2 in BPH was not different from controls. IGFBP-2 and PSA were signi- ficantly correlated with age (r = 0.543 and r = 0.433 respectively) and with each other even when the age effect was removed. Serum IGFBP-2 and PSA levels changed concordantly in all 7 PC patients who had serial sampling. Serum IGF-II but not IGF-I or IGFBP-3 was higher in PC and BPH than in controls (PC 332 ± 23 μg/l), BPH 359 ± 26μg/l vs controls 241 ± 37 μg/l; P = 0.03 and 0.02 respectively). CONCLUSIONS Serum IGFBP-2 levels are uniquely elevated in active prostate carcinoma but not in benign prostatic hypertrophy. In PC, serum IGFBP-2 levels closely parallel those of PSA and probably reflect tumour burden. The relation between PSA and IGFBP-2 is partially independent of their individual relations with age. Although serum IGFBP-2 is less sensitive than PSA in PC, it may have adjunctive value in the management of prostate carcinoma.     

老年前列腺癌患者血清尿酸水平变化及临床意义

目的探讨血清尿酸水平在老年前列腺癌患者与前列腺增生患者之间是否存在差异。方法本研究回顾性分析2010年2月至2019年6月在商丘市第一人民医院诊断为前列腺癌的患者300例,同期诊断为前列腺增生患者240例,前列腺大小正常的老年男性400例作为对照组,检测3组患者血清尿酸水平、血清前列腺特异性抗原(PSA)、C反应蛋白(CRP)、中性粒细胞计数(Neu)、淋巴细胞计数(Lym);观察前列腺癌患者不同临床病理特征时血清尿酸浓度。结果前列腺癌组CRP水平、Neu/Lym明显高于前列腺增生组和对照组,差异有统计学意义(均P<0.05),前列腺癌组尿酸水平为(327.0±58.3)μmol/L、前列腺增生组为(375.2±68.4)μmol/L、对照组尿酸水平为(377.8±73.2)μmol/L,前列腺癌组尿酸水平明显低于前列腺增生组和对照组(F=55.69,P<0.001);多因素Logistic回归结果显示,血清尿酸是前列腺癌发生的保护因素(OR=0.593,95%CI:0.542~0.718,P=0.004)。不同年龄、病理分级的前列腺癌患者尿酸水平差异具有统计学意义(t=-4.63、F=12.73,均P<0.001),但血清尿酸水平与前列腺癌患者临床分期、是否淋巴结转移无明显相关性(F=-2.72、t=0.77,P=0.068、0.460)。结论与前列腺增生患者和正常男性相比,前列腺癌患者血清尿酸浓度降低,而炎性标志物水平升高,表明血清尿酸可能为老年前列腺癌患者发生和发展的危险因素。     

Insulin-like growth factor-binding protein-2 in patients with prostate carcinoma and benign prostatic hyperplasia

OBJECTIVE Insulin-like growth factor-binding protein (IGFBP)-2 is a major prostatic IGFBP and may be involved in regulating prostate growth. Patients with prostate carcinoma (PC) have elevated serum IGFBP-2 levels which correlate with the specific PC marker, prostate-specific antigen (PSA). The aims of this study were (i) to investigate whether elevated serum IGFBP-2 is unique to PC or also occurs in benign prostatic hyperplasia (BPH), (ii) to examine the relationships among age, PSA and IGFBP-2 levels, and (iii) to examine longitudinal changes in serum IGFBP-2 with PSA in PC. DESIGN AND PATIENTS Sixteen patients (61–83 years) with inoperable PC attending the Oncology Unit at a tertiary referral hospital were studied. Some serum samples were obtained retrospectively while the majority were collected prospectively over 13 months of treatment. The patients with PC were compared to eight patients (66–73 years) with histologically-proven BPH and seven male control subjects (61–82 years) with no known prostate abnormality. MEASUREMENTS A new IGFBP-2 RIA was developed. Serum PSA (by EIA), and IGFBP-2, IGFBP-3, IGF-I and IGF-II (by RIA) were measured in all subjects, and serially in patients with PC. RESULTS Serum IGFBP-2 was significantly higher in PC with high PSA (560 ±66 μg/l, n =12) than PC with normal PSA (292 ±65 μg/l, n =4, P =0.02), BPH (364 ±61 μg/l, P =0.03) and controls (367 ±44 μg/l, P =0.04). Mean IGFBP-2 in BPH was not different from controls. IGFBP-2 and PSA were significantly correlated with age (r =0.543 and r =0.433 respectively) and with each other even when the age effect was removed. Serum IGFBP-2 and PSA levels changed concordantly in all seven PC patients who had serial sampling. Serum IGF-II but not IGF-I or IGFBP-3 was higher in PC and BPH than controls (PC 332 ±23 μg/l, BPH 359 ±26 μg/l vs. controls 241 ±37 μg/l; P =0.03 and 0.02 respectively). CONCLUSIONS Serum IGFBP-2 levels are uniquely elevated in active prostate carcinoma but not in benign prostatic hyperplasia. In prostate carcinoma, serum IGFBP-2 levels closely parallel those of prostate-specific antigen and probably reflect tumour burden. The relationship between prostatic-specific antigen and IGFBP-2 is partially independent of their individual relationships with age. Although serum IGFBP-2 is less sensitive than prostate-specific antigen in prostate carcinoma it may have adjunctive value in its management.     

非那雄胺对老年单纯收缩期高血压合并良性前列腺增生患者的疗效及安全性

目的：分析应用非那雄胺对老年单纯收缩期高血压（ISH）合并良性前列腺增生（BPH）患者的疗效及安全性。方法：选择84例2011年6月至2013年5月我院的ISH合并BPH老年患者,依据给药方案不同分为：非那雄胺组（44例）;常规治疗组（40例,行常规治疗不使用非那雄胺）。疗程均为半年,比较两组国际前列腺症状评分（IPSS）、生活质量评分（QOL）,前列腺特异性抗原（PSA）、急性尿潴留发生率、最大尿流率（Qmax）、膀胱残余尿量（PRV）、前列腺体积（PV）以及不良反应发生率。结果：与常规治疗组相比,非那雄胺组的 IPSS 评分[（13.2±2.4）分比（9.4±1.1）分]、PRV [（21.4±4.6）ml比（9.0±2.3）ml]、PV [（36.8±3.8）ml比（29.5±3.0）ml]、PSA [（2.45±0.74）μg/L比（1.26±0.48）μg/L]及急性尿潴留发生率（17.50％比9.09％）显著降低（P＜0.05或＜0.01）,而 Qmax [（10.2±2.4）ml比（13.7±3.8）ml]及 QOL评分[（3.1±1.0）分比（4.7±1.5）分]则显著升高（P＜0.05）。两组各项不良反应发生率无统计学差异（P 均＞0.05）。结论：单纯收缩期高血压合并良性前列腺增生老年患者应用非那雄胺的疗效显著,且不良反应未显著增加。