摘要
目的通过分析α-受体阻滞剂治疗老年良性前列腺增生症(BPH)无效的危险因素,明确初诊老年BPH的药物选择。方法回顾研究96例老年BPH患者,其中单用α-受体阻滞剂坦索罗新治疗组42例,与5α-还原酶抑制剂非那雄胺联合治疗组54例,比较两组国际前列腺症状评分(IPSS)、生活质量指数(QOL)、最大尿流速(Qmax)、残余尿量(PVR)、前列腺体积及血清前列腺特异性抗原(PSA)。结果联合用药与单药治疗组比较,前列腺体积、Qmax和IPSS具有统计学差异;多元回归分析显示IPSS(P<0.001)及前列腺体积(P<0.05)与老年BPH单药治疗无效密切相关。结论老年BPH患者单药及联合治疗均能改善病情,对于初诊时具有较高的IPSS评分及严重的前列腺体积增大者应给予药物联合治疗。
Objective To determine the treatment of criteria for old patients with benign prostatic hyperplasia （BPH） by analyzing the risk factors causing α-blocker monotherapy failure. Methods 96 patients with BPH were enrolled, 42 patients were prescribed an α- blocker tamsulosin. 54 patients were combined with 5 α-reductase inhibitor finasteride. The differences between the two groups for their ini- tial prostate volume, serum prostate-specific antigen （ PSA）, maximum urinary flow rate （ Qmax）, International Prostate Symptom Score （IPSS）, and postvoid residual urine volume （PVR） were compared. Results The prostate volume （41.4 ml vs. 26. 3 ml）, Qmax （6. 3 ml/s vs. 10. 5 ml/s）, and IPSS （23.3 vs. 14. 9） had significant differences （P 〈0.05） between the two groups. The multiple re- gression analysis showed the significant factors in or-blocker monotherapy failure were IPSS （P 〈0. 001 ） and prostate volume （P = 0. 015 ）. Conclusions Both tamsulosin alone and tamsulosin/finasteride combination are effective in reducing the clinical symptoms of old patients with BPH. For the initial diagnosis of BPH, patients with a larger prostate volume and severe IPSS should be combined α-blocker therapy with 5-α-reductase inhibitor （5-ARI）.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2012年第18期3869-3870,共2页
Chinese Journal of Gerontology
基金
国家自然科学基金资助项目(No.81100889)
辽宁省博士启动基金(No.20111106)
关键词
老年
良性前列腺增生症
坦索罗新
非那雄胺
Old patients
Benign prostatic hyperplasia
Tamsulosin
Finasteride
