老年良性前列腺增生夜尿病因分类和相关因素分析

Objective To explore the classification and risk factors of nocturia in patients with benign prostatic hyperplasia (BPH). Methods The 120 males aged 60 years old and over were enrolled who were first diagnosed as BPH or had ceased the BPH medication for at least 3 months.The patients were divided into six groups according to the nocturnal voiding episodes estimated according to the international prostate symptom score (IPSS). All 120 males were inquired about general information and medical histories. The time and volume of intake and voided urine were recorded for 72 hours. The indexes of prostate and bladder function in all cases were also examined and recorded. Results The incidence of nocturia in our study was 79.2%, the incidence of nocturnal polyuria and overactive bladder were 3.3% and 10.8%, respectively. The quality of life was affected by the duration between the time of patients' going to bed and the first time getting up at night. After excluding the cases of nocturnal polyuria and overactive bladder, statistical analysis indicated that the age, and residual urine volume of the bladder were positively associated with nocturia frequencies (NF), the nocturnal voiding volume negatively with NF, while the prostate volume and peak flow rate were not associated with NF. Drinking volume in 24-hours affected the nocturia (P＜0. 01). Conclusions Nocturia is a common complaint in elderly males with BPH and significantly affects the quality of life. The age and the storing function of bladder are more important factors as compared with prostate hyperplasia itself.     

老年良性前列腺增生症患者夜尿症及其相关因素分析

目的探讨老年前列腺增生症患者的夜尿次数及其相关影响因素。方法选取328例初诊或曾药物治疗但停药3个月以上的前列腺增生症患者，记录患者的一般情况、夜尿次数、前列腺及膀胱功能相关指标，并对其结果进行分析。结果随着患者夜尿次数增多，生活质量评分（QOL）逐渐升高。夜尿次数0～1次者平均QOL评分3．45分，夜尿次数2～3次者平均QOI，评分3．57分，夜尿次数4次及以上者平均QOL评分5．08分。通过多因素回归分析显示，患者的年龄及残余尿量与夜尿次数呈正相关，OR值分别为1．06（1．01～1．10）和1．01（1．00～1．01），单次尿量与夜尿次数呈负相关，OR值为1．00（0．99～1．00），差异均有统计学意义（均为P〈0．05）。而前列腺体积和最大尿流率与夜尿次数无相关性。结论夜尿次数增多影响患者的生活质量；相比前列腺增生而言，年龄和膀胱储尿功能对夜尿次数的影响更为重要。     

夜尿次数对中老年人前列腺增生程度预报价值的研究

夜尿次数对中老年人前列腺增生程度预报价值的研究柳士秀（济南军区青岛第一疗养院，青岛２６６０７１）本研究在排除前列腺癌、泌尿系统结核、炎症等后用夜尿次数作为判断排尿困难患者前列腺增生程度的指标，并与超声结果对照，探讨其对前列腺增生程度的诊断价值。１对象...     

良性前列腺增生的病因和诊治

良性前列腺增生（BPH）是一个病理学名词,以前列腺间质和上皮细胞增生为其特征,是老年男性的多发及常见疾病.BPH的组织学可以只表现为显微镜下的增生而不影响前列腺体积的改变.随着我国平均寿命延长,BPH的患病率有逐年增高趋势.施榕等（1999年）运用描述流行病学方法,采用多阶段抽样方法在城市一般人群中抽取上海市区40岁以上男性居民1582例,其中BPH患病率为43%,且其随年龄增加而上升.于普林等（2000年）采用多级、整群抽样的方法,对中国6个城市3361例大于60岁（含60岁）的常住城乡老年男性进行了横断面的流行病学调查,获得BPH总患病率为43.68%,按年龄分组的患病率60～、65～、70～、75～、80～、85～岁者分别为34.48%、40.27%、46.77%、51.44%、57.32%和60.19%,表现出随年龄的增长BPH患病率增加的明显趋势;城市患病率为46.79%,农村患病率为39.64%,城市高于农村;北京大学泌尿外科研究所50年代BPH占住院患者7.6%,而90年代上升至18.5%。     

老年前列腺增生患者疾病感知及相关因素

目的研究老年前列腺增生患者的疾病感知特点。方法选择疾病感知问卷修订版(IPQ-R)、社会支持量表(SSRS)对老年前列腺增生患者进行疾病感知和社会支持状况进行评价,并对其进行相关性分析。结果老年前列腺增生IPQ-R各因子之间Pearson偏相关分析显示病程(急慢性)因子与疾病一致性因子、后果因子、情绪陈述因子、个人控制因子和治疗控制因子显著相关(r=0.369,0.409,0.441,-0.602,-0.460,均P0.05),情绪陈述因子与后果因子、个人控制因子和治疗控制因子显著相关(r=0.333,-0.399,-0.593,均P0.05)。社会支持度主观支持与后果、情绪陈述呈负相关(r=-0.256,-0.379,均P0.05),与治疗控制呈正相关(r=0.407,P0.05);社会支持度客观支持与情绪陈述呈负相关(r=-0.327,P0.05),与治疗控制呈正相关(r=0.544,P0.05)。丧偶患者在病程(急慢性)和情绪陈述因子得分明显高于已婚、有家庭成员照顾的患者(2.97±0.43,2.58±0.51;2.47±0.39,2.80±0.42;均P0.05);在治疗控制因子、主观支持和客观支持得分明显低于已婚的患者(3.65±0.19,3.86±0.22;7.45±1.23,8.61±1.35;17.30±1.30,18.55±1.82;均P0.05)。结论老年前列腺增生患者具有一定程度的负性疾病感知,此外,社会支持度、家庭成员和家庭照顾等因素影响患者的心理应激状态,对患者疾病恢复及生活质量产生影响。     

良性前列腺增生和癌的关系

良性前列腺增生和癌的关系南京大学医学院附属鼓楼医院泌尿外科（２１０００８）周志耀前列腺增生症（ＢＰＨ）与前列腺癌（ＰＣ）共存在一个腺体，是长期有争议的问题。早在１９２２年Ｇｅｒａｐｈｙ就报道ＰＣ中有７５％伴有ＢＰＨ。而在ＢＰＨ中，当今国内外均发现有５...     

老年良性前列腺增生危险因素分析及疗效评价

流行病学研究提示前列腺增生(BPH)相关危险因素包括遗传、营养、免疫等[1～3].近年来调查结果显示代谢综合征(MS)与BPH继发的下尿路综合征的发生有关[4].本文拟研究老年BPH的危险因素及治疗效果.     

良性前列腺增生与肥胖相关性研究

目的 探讨良性前列腺增生(BPH)与肥胖或中心性肥胖的关系.方法 选择老年男性患者109例,分为BPH组(59例)和非BPH组(50例),检测血清前列腺特异性抗原(PSA)及性激素、血脂等相关生化指标;测量身高、体质量、腰围等物理指标;经腹超声测量前列腺体积,并随访至少3次.结果 肥胖组BPH患病率(73.33%)及超体质量组BPH患病率(64.28%)均较正常组(26.67%)增高(x2分别为13.991,6.836,均P＜0.002),中心性肥胖组BPH患病率(71.19%)较非中心性肥胖组(36.00%)明显增高(x2=12.156,P＜0.001);BPH组腰围身高指数、腰围、体质量、体质指数、臀围[0.56±0.05、(93.6±8.8)cm、(72.6±9.7)kg、(25.7±3.4)kg/m2和(100.2±6.6)cm]明显高于非前列腺增生组[0.52±0.06、(87.0±10.1)cm、(64.5±9.3)kg、(23.1±2.9)kg/m2和(95.6±8.1)cm](t分别=-3.30,-3.65,-4.38,-4.17,-3.18,均P＜0.01);肥胖组前列腺总体积高于正常组[(40.8±23.5)ml与(20.1±6.1)ml,t=-2.82,P＜0.01),中心性肥胖组明显高于非中心性肥胖组[(42.8±25.6)ml与(26.9±11.2)ml],(t=-3.93,P＜0.001);中心性肥胖组雌二醇/总睾酮(E2/TT)比值、胰岛素抵抗指数(HOMA-IR)(9.06±4.36、2.81±2.80)高于非中心性肥胖组(7.38±3.11、1.55±0.76)(t分别=-2.02,-4.24,均P＜0.05),血清TT、性激素结合蛋白(SHBG)则低于非中心性肥胖组[(4.54±1.54)nmol/L对(5.20±1.54)nmol/L,(45.8±17.24)nmol/L对(59.6±26.09)nmol/L,均t分别=2.16,2.79,P＜0.05];Logistic逐步回归分析表明,腰围是影响前列腺体积的主要因素(x2=19.52,P=0.000);前列腺总体积的年增长率在肥胖组同样高于正常组[(7.14±8.09)ml与(1.49±5.14)ml,t=-2.19,P＜0.05],在中心性肥胖组明显高于非中心性肥胖组[(7.96±13.81)ml与(1.35±5.36)m1,t=-3.28,P＜0.01];中心性肥胖组的前列腺特异性抗原密度(PSAD)低于非中心性肥胖组(0.048±0.036对0.090±0.093,t=2.02,P＜0.05);肥胖组的PSAD低于正常组(0.052±0.039与0.091±0.080,t=3.13,P＜0.01).结论 BPH的发生与肥胖,尤其是中心性肥胖密切相关,其机制可能与肥胖患者体内性激素失衡、生长激素-胰岛素样生长因子轴的紊乱有关.

Abstract：

Objective To explore the relationship between benign prostatic hyperplasia (BPH)and obesity. Methods The 109 elder men were divided into two groups: BPH group (n=59) and non-BPH group (n= 50). The blood samples were collected for the detections of prostate specific antigen (PSA), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), insulin,androgen, estrogen, sex hormone binding globulin (SHBG) and dehydroepiandrosterone(DHEA).The anthropometric indexes including height, body weigh, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were measured and calculated. The total prostate volume (TPV) were measured by transabdominal ultrasonography three times at least. Results The morbidity rate of BPH was significantly higher in obesity group and over weight group than in health control group (73.33% and 64.28% vs. 26. 67%, x2 = 13. 991 and 6. 836, both P＜0. 002). So was in central obesity group versus in health control group (71.19% vs.36.00%, x2 =12. 156, P＜0. 001). The waist-height index, waist circumference, body weight, BMI and hip circumference were significantly higher in BPH group than in non-BPH group [(0. 56±0. 05)vs. (0.52±0.06), (93. 6±8.8) cm vs. (87.0± 10. 1) cm; (72.6±9.7) kg vs. (64.5±9.3) kg;(25.7±3.4) kg/m2 vs. (23.1±2.9) kg/m2; (100.2±6.6) cm vs. (95.6±8. 1) cm; t=-3.3, -3. 65, -4.38, -4. 17 and -3.18, respectively, all P＜0.01]. The TPV was higher in obesity groupthan in normal group [ (40.8± 23.5 ) ml vs. (20. 1 ± 6.1 ) ml, t = - 2.82, P＜ 0. 002] and obviously higher in central obesity group than in non-central obesity group [(42.8±25.6)ml vs. (26. 9±11.2)ml, t= -3. 93, P＜0. 001]. The ratio of E2/TT and HOMA-IR were higher in central obesity group [(9. 06±4.36) and (2.81 ±2. 80)] than in non-central obesity group [(7. 38±3. 11) and (1. 55±0.76), t= -2.02 and -4.24, both P＜0. 05]. Inversely, the TT and SHBG were lower in central obesity group than in non-central obesity group [(4.54 ± 1.54) nmol/L vs. (5.20 ± 1.54) nmol/L,(45.8± 17.24) nmol/L vs. (59.6 ± 26.09) nmol/L, t = 2.16 and 2.79, both P＜ 0. 05]. Logistic regression analysis showed that waist circumference was a major factor affecting TPV (x2= 19.52, P=0. 000). The annual growth rate of TPV was significantly higher in obesity group and central obesity group than in health control group [(7. 14±8. 09)ml vs. (1. 49±5.14)ml, (7. 96±13.81)mlvs. (1. 35±5.36)ml, t=-2.19 and -3.28, both P＜0. 05]; The PSAD was significantly lower in central obesity group than in health control group [(0. 048±0. 036) vs. (0. 090±0. 093), t=2.02, P＜0. 05], and lower in obesity group than in health control group [(0. 052 ±0. 039) vs. (0. 091 ±0. 080), t= 3. 13, P＜0. 01]. Conclusions The occurrence of BPH is closely related to obesity,especially central obesity. Its mechanism may be related to sex hormone imbalance and the GH/IGF-1 axis disorders in obese patients.     

中国11城市医院老年科就诊良性前列腺增生患者患病情况及相关因素分析

目的 调查就诊于老年科的老年人中良性前列腺增生(BPH)患者的患病情况.方法 采用分层整群随机抽样的方法,对11个城市医院老年科2125例60岁及以上的就诊老年人进行横断而流行病学调查.结果 BPH占就诊疾病的构成比为47.0%,BPH患者按年龄分组60～、70～、80～岁的构成比分别为18.1%、49.4%、32.5%,BPH患者各年龄组构成比差异有统计学意义(x2=83.68,P<0.001);BPH患者职业分布存在差别,国家机关人员和专业技术人员构成比较高,分别为66.4%和18.0%,农林牧副渔业人员构成比较低为14.7%(x2=410.27,P<0.001).BPH患者下尿路症状严重程度[国际前列腺症状评分(IPSS)]在城市间不同(x2=101.00,P相似文献   

老年科良性前列腺增生的诊治现状

目的 了解良性前列腺增生(benign prostate hyperplasia,BPH)在老年科的诊断和治疗现状,促进BPH诊断和治疗的规范化.方法 抽取我国23个城市的老年科门诊BPH患者,完成老年科BPH门诊登记调查表.问卷内容包括患者的基本情况、诊疗情况和治疗效果.结果 对4001份调查问卷的分析显示,患者平均国际前列腺症状评分(IPSS)(18.8±5.9)分,中、重度症状患者分别占53.8％和42.0％.并存疾病的患病率依次为高血压(63.9％)、冠心病(40.4％)、糖尿病(32.4％)和高脂血症(25.7％).BPH相关并发症的发生率依次为尿路感染(21.0％)、尿路结石(8.3％)、反复血尿(1.8％)、肾积水(1.7％)和疝气(0.6％).医师采用的诊疗手段中,未进行直肠指诊的占27.2％,未进行血清前列腺特异性抗原(PSA)检查的占89.5％.在药物治疗的患者中,68.1％的患者处方中有a受体阻滞剂,92.9％的处方中有5α还原酶抑制剂,11.8％的处方中有中药和植物制剂,0.4％的处方中有M受体阻滞剂.首次处方中,单药治疗的占51.1％,2种药物联合治疗的占46.6％.在中重度症状患者中,遵医嘱规律服药的占60.6％,已停药的占13.9％.需要调整处方的原因依次为药物疗效差(23.4％)、不良反应多(5.4％)、价格昂贵(3.5％)、服用不方便(2.9％)等.结论 老年科门诊BPH患者以中重度症状为主,BPH治疗的同时还需考虑并存的疾病和BPH相关并发症;医师需进一步认识直肠指诊和PSA检查的重要性,联合治疗对于改善患者下尿路症状效果显著,长期治疗效果更好.     

老年前列腺增生症患者逼尿肌功能变化的尿动力学检测意义

目的探讨前列腺增生症（ＢＰＨ）患者逼尿肌功能变化的尿动力学特点及其临床意义。方法应用尿动力学技术,检查３５例ＢＰＨ患者的尿流率、膀胱充盈期和排尿期压力、膀胱感觉,观察膀胱容量－压力相关关系,测定剩余尿量,评估膀胱的稳定性、顺应性及逼尿肌受损程度。结果逼尿肌不稳定２２例（６２．９％）,逼尿肌收缩功能受损８例（２２．９％）,膀胱顺应性改变５例（１４．２％）,表明ＢＰＨ可引起逼尿肌功能变化。结论尿动力学对判断逼尿肌功能状态、确定排尿功能障碍原因、选择药物治疗或手术适应证有重要意义。     

甲磺酸多沙唑嗪控释片治疗良性前列腺增生及改善勃起功能的研究

目的 研究甲磺酸多沙唑嗪控释片对良性前列腺增生(BPH)患者下尿路症状(LUTS)及性功能的影响.方法 101例典型的伴有LUTS的BPH患者治疗前进行国际前列腺症状评分(IPSS)、勃起功能障碍国际问卷5(IIEF2-5)调查,给甲磺酸多沙唑嗪控释片4 mg,1次/d,疗程8周.分析治疗后LUTS及性功能改善情况.结果 治疗前IPSS评分(19.9±6.5)分,治疗后(14.3±4.0)分(t=7.534,P＜0.001);治疗前IIEF-5评分(9.5±8.5)分,治疗后(14.9±8.8)分(t=5.335,P＜0.001),治疗后各项指标较治疗前有明显改善.IPSS和IIEF2-5呈负相关(r=-0.33,P＜0.001).结论 LUTS是性功能障碍的危险因素,LUTS的严重程度与性功能障碍的发展密切相关.甲磺酸多沙唑嗪控释片在改善LUTS的同时可明显改善患者的性功能状况.

Abstract：

Objective To study the therapeutic effect of cardura on lower urinary tract symptoms (LUTS) and ejectile dystunction(ED) in men with benign prostatic hyperplasia (BPH).Methods One hundred and one cases with BPH and typical LUTS were investigated using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function 5 (IIEF-5)before and after treatment. The patients were given cardura 4 mg, once a day for 8 weeks. The LUTS and ED were was analyzed after treatment. Results The IPSS was scores ( 14.3 ± 4.0) after treatment, and it was lower than before (mean scores: 19.9±6.5, t= 7.534, P＜0.001). The IIEF2-5 was(14.9±8.8)scores after treatment, and it was higher than before (mean scores: 9.5±8. 5, t = 5. 335, P＜ 0. 001 ), respectively. There was statistically significant correlation between IIEF2-5 and IPSS score (r= -0. 327, P＜0. 001 ). Various indexes were significantly improved after cardura treatment as compared with pretreatment (P＜0.001). Conclusions LUTS is dangerous factor for sexual dysdysfunction, and the severity of LUTS is closely related to the development of sexual dysfunction. Cardura can at once improve the sexual function and LUTS of BPH patients.     

前列腺增生合并慢性前列腺炎临床分析

目的 观察良性前列腺增生症(BPH)合并慢性前列腺炎患者在同时接受慢性前列腺炎药物治疗时,其临床症状的改变.方法 BPH诊断明确并接受药物治疗半年以上而自觉疗效不甚理想的98例BPH患者,按美国国立卫生院制定的慢性前列腺炎症状评分(NIH-CPSI),诊断标准均符合慢性前列腺炎诊断(CPSI＞4分).将其分为治疗组(52例)和对照组(46例),治疗组在不改变原治疗方案的情况下同时给予慢性前列腺炎的药物治疗,包括选用高解离系数和高脂溶性的大环内脂类或喹诺酮类抗生素药物,非选择性M胆碱受体阻滞剂及前列安栓等中成药,并戒酒和辛辣食物,同时采用温水坐浴等物理治疗;对照组则继续原前列腺增生治疗方案.观察两组治疗2个月后的症状改变情况.结果 治疗组治疗后国际BPH症状评分(I-PSS)由治疗前的(11.7±2.8)分降至治疗后的(10.1±2.4)分,其中尿频、尿急和尿不尽的症状评分均值分别由治疗前的(1.7±0.9)、(2.6±1.0)和(2.0±1.1)分降至治疗后的(1.5±0.9)、(2.1±0.9)和(1.4±0.9)分,治疗前、后比较差异均有统计学意义(P＜0.01).CPSI均值由治疗前(9.7±2.4)分减少至治疗后的(6.7±1.8)分,其中疼痛症状、排尿症状、严重程度分别由治疗前的(2.9±1.6)分、(3.7±1.5)分和(3.1±1.4)分减少至治疗后的(1.8±1.1)分、(2.8±1.0)分和(2.1±1.2)分,治疗前、后比较,差异均有统计学意义(P＜0.01).而对照组治疗前、后FPSS和CPSI各项评分差异均无统计学意义.结论 前列腺增生症患者在接受系统前列腺增生治疗后,如症状仍无明显改善,且按NIH-CPSI评分符合慢性前列腺炎的诊断标准,可同时给予前列腺炎治疗,患者的部分症状可得到明显改善.     

前列腺增生症术后下尿路症状的病因分析

对前列腺切除术后出现下尿路症状者38例进行尿动力学检查并分析。结果显示：38例中有逼尿肌功能障碍者21例,其中单纯逼尿肌反射低下11例,逼尿肌反射低下伴下尿路梗阻6例、逼尿肌过度活动4例,下尿路梗阻者17例,其中膀胱颈梗阻14例,尿道狭窄3例,认为逼尿肌功能障碍、膀胱颈梗阻是前列腺术下尿路症状的主要原因,尿动力学检查可明确诊断,并为二次治疗的方法提供依据。     

良性前列腺增生患者腔内手术后谵妄发生的临床分析

目的 预防良性前列腺增生(BPH)患者腔内手术后谵妄的发生. 方法 总结我院接受腔内手术治疗的370例BPH患者的临床资料,分析患者年龄、并存疾病、手术方法、手术时间以及术后疼痛等因素对谵妄产生的影响. 结果 370例患者术后共发生谵妄19例,发生率5.1%.单因素分析显示,患者年龄(χ~2=7.37,P<0.05)、并存疾病(χ~2=10.26,P<0.05)、手术时间(χ~2=19.87,P<0.05)以及术后疼痛(χ~2=4.99,P<0.05)这4个因素与谵妄发生有关;多因素Logistic回归分析显示患者年龄(OR=5.38,P<0.05)、并存疾病(OR=4.97,P<0.05)、手术时间(OR=6.52,P<0.05)是谵妄发生的重要影响因素. 结论 对BPH高龄患者应特别注意改善其全身情况,做好充分的术前准备,缩短手术时间等对预防术后谵妄有积极意义.     

长期应用非那雄胺治疗良性前列腺增生临床疗效及安全性

目的 观察服用非那雄胺14年治疗良性前列腺增生(BPH)的临床疗效及安全性.方法 对1994年12月至2009年2月连续服用非那雄胺(5 mg/d)治疗BPH的41例患者进行临床观察,记录治疗前后患者夜尿次数、前列腺体积、血肌酐、丙氨酸氦基转移酶(ALT)、血白细胞、血清前列腺特异抗原(PSA)变化;同时记录治疗期间发生急性尿潴留、接受外科治疗及药物特殊不良作用(如乳腺癌和前列腺癌等)临床资料. 结果 本组41例患者观察终止时平均年龄(87.9±5.4)岁,平均治疗时间(141.1±27.1)个月.治疗前后,患者夜尿次数分别为(1.8±1.5)次和(3.2±1.3)次,差异有统计学意义(t=-4.52,P<0.05);前列腺体积分别为(44.9±26.6)ml和(42.8±31.3)ml,差异无统计学意义(t=0.33,P>0.05).分层研究发现,治疗前前列腺体积<25 ml者,治疗后体积增大17.3%(t=-0.88,P>0.05);治疗前体积25～40 ml者,治疗后体积缩小17.2%(t=2.59,P<0.05);治疗前体积>40 ml者,治疗前后体积缩小1.1%(t=0.07,P>0.05).治疗前后患者血肌酐分别为(96.8±18.6)μmol/L和(86.4±32.3)μmol/L(t=1.79,P>0.05),血白细胞计数分别为(6.4±1.5)×109>/L和(6.0±1.7)× 109/L(t=1.13,P>0.05),PSA分别为(1.2±2.0)μg/L和(1.4±1.7)μg/L(t=-0.49,P>0.05).本组3例(7.3%)发生急性尿潴留,经导尿后好转;无确诊前列腺癌和乳腺癌病例. 结论 BPH患者长期服用非那雄胺可以有效控制BPH的临床进展,无严重并发症.     

长期应用非那雄胺治疗良性前列腺增生临床疗效分析

目的 探讨长期应用非那雄胺治疗良性前列腺增生(BPH)的临床疗效及安全性.方法 观察患有BPH并坚持服用非那雄胺5 mg/d治疗7年以上的患者并分析其临床资料.结果 患者治疗前后前列腺体积分别为(48.0±12.5)ml和(41.0±8.4) ml,治疗后前列腺体积明显缩小(t=2.04,P＜0.05).血清前列腺特异抗原(PSA)治疗前后分别为(3.8±1.5)μg/L和(1.5±1.1)μg/L,差异有统计学意义(t=5.30,P＜0.05),治疗后2倍PSA值为(2.9±2.2)μg/L,较治疗前差异无统计学意义(t=1.38,P＞0.05).国际前列腺症状评分(IPSS)治疗后有显著改善[(21.1±7.0)分与(17.1±4.5)分,t=2.09,P＜0.05].治疗期间1例患者发生急性尿潴留,1例患者出现肉眼血尿,未见其他不良反应.结论 长期应用非那雄胺治疗良性BPH疗效好,不良反应小,值得临床推广.     

老年人代谢综合征与良性前列腺增生的关系

目的 回顾性分析老年代谢综合征(MS)与良性前列腺增生(BPH)的关系.方法 老年男性859名,其中单纯MS患者8例,单纯BPH患者619例,两种疾病并存者192例,未患病者40例.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),并计算体质指数(BMI)、前列腺体积及前列腺年增长率(PG),分析代谢性危险因素与BPH的相关性.结果 BPH患者MS组与非MS组相比收缩压、舒张压、体质量、BMI、TG及FBG偏高(t=6.15、5.99、13.12、15.56、10.63、9.94,均P＜0.01),HDL-C浓度偏低(t=-7.57,P＜0.01);随着MS组分个数的增加,前列腺体积增加(F=2.98,P=0.031);随着年龄、体质量、BMI、收缩压、PG的增加,前列腺体积增大(t值分别为-6.39、-2.39、-2.36、-2.13、-25.85,均P＜0.05);前列腺体积与年龄、收缩压、体质量、BMI、血压升高呈正相关(r值分别为0.229、0.079、0.090、0.089、0.088,均P＜0.05);非条件Logistic回归分析校正混杂因素后,年龄、体质量和收缩压＞130 mm Hg(1 m Hg=0.133 kPa)为前列腺增生的独立相关因素(OR值分别为1.07、1.03、1.34,均P＜0.05).结论 老年患者BPH与MS有关,MS可能参与老年人BPH的发生发展过程,但其机制尚有待进一步研究.

Abstract：

Objective To retrospectively analyze the relationship between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS) in senior patients. Methods The 859 male senior patients including 619 cases with BPH and 8 cases with MS were enrolled in this study, and there were 192 cases with both diseases and 40 controls. The levels of fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. The body mass index (BMI), prostate volume and annual prostate growth rate were determined or calculated. The correlations of BPH with other metabolic risk factors were analyzed. Results The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, BMI, TG and FPG were higher (t=6.15, 5.99, 13.12, 15.56, 10.63 and 9.94, all P＜0.01), while serum HDL-C level was lower (t=-7.57,P＜0.01) in BPH patients with MS than without MS. As the number of components of MS was increased, the prostate volume was increased (F=2.98, P=0.031). As the age, body weight, BMI, SBP and PG were increased, the prostate volume was increased (t=-6.39,-2.39,-2.36,-2.13,-25.85,all P＜0.05). Spearman analysis showed that prostate volume was positively correlated with age, SBP, body weight, BMI and hypertension (r=0.229, 0.079, 0.090, 0.089 and 0.088, all P＜0.05). And age, body weight and SBP were the independent risk factors for BPH (OR=1.07, 1.03 and 1.34, all P＜0.05). Conclusions The present study demonstrates a relationship between BPH and MS in senior patients. Future studies are needed to confirm our results and to explain underlying mechanisms.