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

Objective To study the present situation of benign prostatic hyperplasia (BPH) of male patients in geriatrics department. Methods Two thousand one hundred and twenty-five patients aged 60 years and above with BPH in geriatrics department of Chengdu, Lanzhou, Hangzhou, Wuhan, Changsha, Guangzhou, Shenyang, Shanghai, Nanjing, Jinan and Beijing were investigated using stratified cluster random sampling method. Results The constituent ratio of patients with benign prostatic hyperplasia in geriatrics department was 47.0%, and the proportions of the elderly of 60～,70～ ,80～ years old among the patients with benign prostatic hyperplasia were 18.1%,49.4 and 32.5%, respectively (x2 = 83.68, P<0.001). There was a significant difference in the occupation distribution of BPH constituent ratio: 66.4% for staffs of state organs, 18.0% for professional technical personnel and 14.7% for works and peasants (x2=410.27,P<0.001). The international prostate symptom scores (IPSS) were different among different cities (x2=101.00, P<0. 001 ). Logistic regression analysis showed that the IPSS was correlated with age and profession (age: OR= 1.029;worker and peasant as control group, working staff of state organs OR=O.707, professional technical personnel OR=0.339 ). Conclusions The benign prostatic hyperplasia is a common disease in male elderly patients in China, but the consultation rate is low. The IPSS of benign prostatic hyperplasia is correlated with age and profession. Prevention and treatment of benign prostatic hyperplasia in the elderly should be strengthened.     

老年人良性前列腺增生与心血管疾病的关系

Objective To realize the clinical characteristics and treatment strategies in elderly patients with benign prostatic hyperplasia (BPH), and investigate the correlation between severity of BPH and cardiovascular diseases. Methods One hundred consecutively referred patients with BPH were enrolled in this study, and the international prostate symptom score (IPSS) and quality of life (QOL) scores were recorded. All patients were queried in detail about history of cardiovascular disease, and underwent detection of prostate specific antigen (PSA) levels, prostate volume (PV)measurement by abdominal ultrasound. Results PV and serum PSA level increased with age.Forty-eight percent of patients had a moderately enlarged prostate (IPSS 8-19). Patients with BPH had higher incidence of hypertension, diabetes, as well as coronary artery disease (P＜0.05). The most common medical treatments were 5α-reductase inhibitors and a-receptor blockers in our hospital and most patients had good compliance. Conclusions The severity of BPH is correlated with age and morbidity of coronary artery disease. For the drug intervention therapy, 5a-reductase inhibitors have the highest utilization rate.     

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.     

磁共振波谱成像对中央腺体前列腺癌与良性增生结节的鉴别诊断

Objective To explore the metabolic characteristic of prostate cancer (PCa) in central gland with magnetic resonance (MR) spectroscopic, and evaluate the value of MRS in the differential diagnosis of benign prostatic hyperplasia nodus. Methods MR images were performed in 38 cases with prostate disease by 3.0T MR, 11 cases with PCa in central gland and 27 cases with benign prostatic hyperplasia nodus. All the cases were scanned by routine, then by the combined MRS. MRS findings were reviewed in 27 cases with benign prostatic hyperplasia (BPH) and 11 cases with PCa (3 in central gland origin, 8 with large tumor invading both peripheral zone and central gland). (Cho+Cr)/Cit ratios of PCa and BPH were retrospectively measured, (Cho+Cr)/Cit of PCa voxels were compared with that of BPH voxels. Results Significantly higher choline levels and lower citrate levels were observed in central gland of PCa compared with BPH. In the glandular BPH region, the amount of Cit was high; while in the stromal region, the Cit and Cho level was much lower. The average (Cho+Cre)/Cit values of PCa and BHP were 1.94±1.43 and 0. 83±0. 28 respectively, the difference in ratio between both was statistically significant (P＜0. 01). Conclusions The combined use of MRI and MR spectroscopy is propitious for differentiating prostate cancer in central gland and benign prostatic hyperplasia nodus and for increasing the diagnostic accuracy of prostate cancer.     

磁共振扩散加权成像在前列腺癌诊断和鉴别诊断中的价值

目的 探讨磁共振扩散加权成像(DWI)和表观弥散系数(ADC)值在前列腺癌诊断与鉴别诊断中的应用价值.方法 46例经手术病理或穿刺活检证实的前列腺疾病患者行DWI检查,其中前列腺增生(BPH)21例,慢性前列腺炎9例,前列腺癌16例,扩散敏感分数值800 s/mm2.依病理结果,将前列腺外周带六分区归类为正常区、增生区,炎症区、癌区,测量每个分区的ADC值,癌与非癌组之间进行受试者操作特征曲线(ROC)分析.结果 各组ADC值分别为,BPH外周带(2.20±0.29)×10-3mm2/s,中央带(1.66±0.14)×10-3 mm2/s,炎症区(1.95±0.34)×10-3 mm2/s,癌区(1.24±0.32)×10-3 mm2/s,组间ADC值两两比较,差异均有统计学意义(均P＜0.01);ROC曲线上临界点取1.49×10-3 mm2/s,诊断的敏感性达86.8%,特异性为94.0%,ROC曲线下面积0.945±0.010.结论 前列腺DWI及ADC值可用于前列腺肿瘤的诊断和鉴别诊断,具有很高的临床应用价值.

Abstract：

Objective To explore the application of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value in the diagnosis and differential diagnosis of prostatic cancer. Methods Diffusion-weighted echo-planar imaging (EPI) sequences were performed in 46 patients, including 21 cases of benign prostatic hyperplasia (BPH), 9 cases of chronic prostatitis and 16 cases of prostate cancer. DWI were obtained with a b-factor of 800 s/mm2. According to the pathological results obtained by ultrasound guided biopsy, the peripheral zone of prostate was divided into six parts by orientations and they were divided into noncancerous, hyperplasia, prostatitis and cancerous groups. The ADC value of each region was measured and analyzed with one-way ANOVA and ROC analysis. Results Acceptable images for ADC measurement were obtained in all cases.The mean ADC values of prostatic peripheral zone, prostatic central gland, inflammatory area and cancerous area were (2.20±0. 29)×10-3 mm2/s, (1.66±0.14)×10-3 mm2/s, (1.95±0.34)×10-3 mm2/s and ( 1.24 ± 0.32) × 10-3 mm2/s, respectively. There were statistically significant differences in ADC values between the inter-groups (P＜0. 01 ). With ROC cut point setting to 1.49 ×10-3 mm2/s, the diagnostic sensitivity and specificity for prostate cancer were 86. 8% and 94. 0%, the area under the ROC curve (AUC) was 0. 945±0. 010. Conclusions ADC value might be useful to evaluate prostate cancer. DWI has an important clinical application value in the diagnosis and differentiation of prostate cancer.     

酶联免疫吸附法测定血小板反应素1及其对前列腺癌诊断价值的研究

Objective To use enzyme-linked immunosorbent assay (ELISA) for measuring thrombospondin-1 (TSP-1),and to analyze its diagnostic value for prostatic carcinoma.Methods The possible difficulties and the way to solve the difficulties with ELISA spot were explored first.Three agents which could segregate idio-antigen and one technique which could depurate proteinum were designed and developed.The non- idio- proteinum cross reaction problems were solved and the routine method to measure TSP-1 with ELISA was set up successfully.The serum TSP-1 was measured in 14 patients with benign prostatic hyperplasia (BPH) and 18 patients with prostatic carcinoma.Results The TSP-1 values were (73.77±12.72)% and (121.86±-19.47)% in prostatic carcinoma group and benign prostatic hyperplasia group,respectively (t= 8.44,P＜0.01).The diagnostic sensitivity and specificity of TSP-1 and prostate specific antigen (PSA) for prostatic cancer were 92.7%,88.9% and 85.7%,66.7%,respectively (P＜0.01).The area under the receiver operating characteristic curve (ROC) of TSP-1 and PSA were 0.9663 and 0.7421 (P＜0.05).Conclusions The determination of TSP-1 with ELISA is feasible.TSP-1 is an ideal diagnostic parameter for prostatic carcinoma and it may distinguish BPH from malignant prostatic disease more exactly than PSA.     

酶联免疫吸附法测定血小板反应素1及其对前列腺癌诊断价值的研究

Objective To use enzyme-linked immunosorbent assay (ELISA) for measuring thrombospondin-1 (TSP-1),and to analyze its diagnostic value for prostatic carcinoma.Methods The possible difficulties and the way to solve the difficulties with ELISA spot were explored first.Three agents which could segregate idio-antigen and one technique which could depurate proteinum were designed and developed.The non- idio- proteinum cross reaction problems were solved and the routine method to measure TSP-1 with ELISA was set up successfully.The serum TSP-1 was measured in 14 patients with benign prostatic hyperplasia (BPH) and 18 patients with prostatic carcinoma.Results The TSP-1 values were (73.77±12.72)% and (121.86±-19.47)% in prostatic carcinoma group and benign prostatic hyperplasia group,respectively (t= 8.44,P＜0.01).The diagnostic sensitivity and specificity of TSP-1 and prostate specific antigen (PSA) for prostatic cancer were 92.7%,88.9% and 85.7%,66.7%,respectively (P＜0.01).The area under the receiver operating characteristic curve (ROC) of TSP-1 and PSA were 0.9663 and 0.7421 (P＜0.05).Conclusions The determination of TSP-1 with ELISA is feasible.TSP-1 is an ideal diagnostic parameter for prostatic carcinoma and it may distinguish BPH from malignant prostatic disease more exactly than PSA.     

经尿道前列腺等离子电切治疗80岁及以上前列腺增生患者临床观察

目的 探讨经尿道前列腺等离子双极电切术(PKRP)治疗80岁及以上前列腺增生 (BPH)患者的有效性及安全性.方法 回顾分析PKRP治疗的180例80岁及以上高危BPH患者的临床资料.结果 180例手术顺利,手术操作时间平均(45.5±23.3)min.平均切除前列腺(60.3±23.3)g,无输血病例,术中无闭孔神经反射电切综合征出现.术后国际前列腺症状评分由(29.5±5.3)分降至(10.2±2.8)分;最大尿流率由(6.2±1.8)ml/s上升至(24.5±3.1)ml/s;生活质量评分由术前的(7.2±1.1)分下降至(1.0±0.5)分;残余尿由(130.5±45.5)ml降至(13.5±7.1)ml(均P＜0.05).结论 PKRP具有安全性高、并发症少、前列腺切尽率高、疗效确切等优点,适宜高龄BPH患者的手术治疗.

Abstract：

Objective To study the efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) in treatment of benign prostate hyperplasia in elderly patients aged 80 years and over. Methods Retrospective clinical analysis of 180 case of high risk of benign prostate hyperplasia treated by PKRP in patients aged 80 years and over. Results All the 180 patients underwent the operation successfully. The average time for operation was (45.5±23.3) min and the resected prostate was in an average of (60.3±23.3) g. Neither of blood transfusion during the operation nor aductor reflex and transurethral resection syndrome occurred. International prostate symptom score,residual urine and quality of life decreased from (29.5±5.3) to (10.2±2.8),from (130.5±45.5) ml to (13.5±7.1)ml and from (7.2±1.1) to (1.0±0.5) respectively. The maximum flow rate elevated from (6.2±1.8) ml/s to (24.5±3.1) ml/s. The differences in the above indicators were statistically significant between pre- and post- operation (P＜0.05). Conclusions Transurethral plasmakinetic prostatectomy is a reliable and effective surgical method, especially for the aged patients with benign prostate hyperplasia.     

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.     

B型超声对社区中老年脂肪肝的诊断及临床应用研究

目的探讨B型超声技术在社区诊断中老年人群脂肪肝的诊断、发病情况及特点的应用价值。方法应用B型超声对3210名中老年进行体检筛查,同时检测相关指标。结果本组中老年人脂肪肝总患病率为21.0%（674/3210）。女性检出率18.06%（280/1550）,男性检出率23.73%（394/1660）,男、女脂肪肝检出率间差异无统计学意义（P〉0.01）。Logistic回归分析表明,肥胖、高三酰甘油血症、高胆固醇血症、高血压、糖尿病或糖耐量异常、高尿酸血症等为脂肪肝的危险因素（P〈0.05）,而性别、年龄无相关性（P〉0.05）。结论B型超声对中老年脂肪肝的诊断具有重要的应用价值;中老年应注意饮食平衡及加强锻炼,改变不良生活行为习惯,预防脂肪肝疾病的发生。     

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.     

Canine prostate carcinoma: epidemiological evidence of an increased risk in castrated dogs

The present retrospective study investigated the frequency of prostate carcinoma (PCA) among prostate abnormalities in dogs and determined whether castration influences the incidence of PCA in dogs. During the years 1993-1998, 15,363 male dogs were admitted to the Utrecht University Clinic of Companion Animals, and of these dogs 225 were diagnosed with prostatic disease. In addition, another 206 male dogs were diagnosed as having prostatic disease based on cytologic examination of aspiration biopsies submitted by referring veterinarians. Benign prostatic hyperplasia was diagnosed in 246 dogs (57.1%), prostatitis in 83 dogs (19.3%), and PCA in 56 dogs (13%). Dogs with PCA were significantly older (mean age=9.9 years) than dogs with other prostatic diseases (mean age=8.4 years). The Bouvier des Flandres breed had an increased risk (odds ratio (OR)=8.44; 95% CI 4.38-16.1) of having PCA. Castration (26/56) increased the risk (OR=4.34; 95% CI 2.48-7.62) of PCA. The mean age at diagnosis of PCA in castrated dogs and in intact male dogs was not significantly different. The interval between castration and onset of prostatic problems was highly variable, suggesting that castration does not initiate the development of PCA in the dog, but it does favour tumor progression.     

Effect of growth hormone (GH) and insulin-like growth factor I on prostate diseases: an ultrasonographic and endocrine study in acromegaly, GH deficiency, and healthy subjects.

The role of insulin-like growth factor I (IGF-I) in prostate development is currently under thorough investigation because it has been claimed that IGF-I is a positive predictor of prostate cancer. To assess the effect of GH and IGF-I levels on prostate pathophysiology, 46 acromegalic (30 in active disease, 10 cured from acromegaly, and 6 affected from GH deficiency) and 30 age-matched male controls, free from previous or concomitant prostate disorders, underwent pituitary, androgen, and prostate hormonal assessments and transrectal ultrasonography. Compared to control values, GH (P < 0.0001), IGF-I (P < 0.0001), and IGFBP-3 (P < 0.001) levels were increased, whereas testosterone (P < 0.0001) and dihydrotestosterone levels (P < 0.0001) were reduced in active acromegalic patients. Hypogonadism was present in 28 of the 46 acromegalic patients (60.8%). The anteroposterior (P < 0.05), and transverse (P < 0.0001) prostate diameters and the transitional zone volume (P < 0.05) were increased in acromegalic patients compared to those in controls. Prostate volume (PV) was significantly higher in untreated acromegalic patients than in controls (41.7 +/- 3.2 vs. 21.9 +/- 1.4 mL; P < 0.0001), cured patients (23.6 +/- 1.6 mL; P < 0.0001), and GH-deficient patients (17.5 +/- 1.1 mL; P < 0.0001). In the patients, PV was correlated with disease duration (r = 0.606; P < 0.0001) and age (r = 0.496; P < 0.0001), whereas in controls it was correlated with age (r = 0.476; P < 0.01) and IGF-I levels (r = -0.448; P < 0.05). Benign prostate hyperplasia (PV > or = 30 mL) was found in 58% of the acromegalics and 26.6% of the controls. When grouped by age (<40, 40-60, and >60 yr), PV was increased in elderly patients compared to younger patients (P < 0.05) and to controls (P < 0.01). The prevalence of structural abnormalities, including calcifications, nodules, cysts, and vesicle inflammation, was significantly increased in patients compared to controls (78.2% vs. 23.3%; chi2 = 5.856; P < 0.05). No clinical, transrectal ultrasonography, or cytological evidence of prostate cancer was detected in acromegalic or control subjects. In conclusion, chronic excess of GH and IGF-I cause prostate overgrowth and further phenomena of rearrangement, but not prostate cancer.     

Effect of two years of growth hormone and insulin-like growth factor-I suppression on prostate diseases in acromegalic patients

The insulin-like growth factors (IGFs) have mitogenic effects on normal and tumoral prostate epithelial cells and have been suggested to be involved in prostate cancer. Moreover, chronic GH and IGF-I excess causes prostate overgrowth in patients with acromegaly. This study was designed to investigate whether the suppression of GH and IGF-I levels by surgery or pharmacotherapy could induce the regression of prostatic hyperplasia in acromegalic patients. To this end, prostate volume (PV) as well as the occurrence of prostatic diseases were studied by transrectal ultrasonography in 23 untreated acromegalic patients (with elevated GH and IGF levels). None of the patients reported symptoms due to prostatic disorders or obstruction. At study entry, prostate hyperplasia was found in half patients. After 2 yr, GH, IGF-I, and IGFBP-3 levels were decreased, whereas prostate-specific antigen levels did not change. PV was decreased in the 16 patients who were well controlled. Among the 6 patients with prostate hyperplasia at study entry who achieved disease control, 4 regained a normal PV at the end of the 2 yr of treatment, whereas none of the 5 patients with prostate hyperplasia at study entry and not achieving disease control normalized their PV. When patients were divided according to age, prostate volume decreased after 2 yr only in the 8 controlled patients aged below 50 yr, but not in those controlled and with age above 50 yr despite similar decrease in GH, IGF-I, and IGFBP3 levels. No clinical, transrectal ultrasonography, or cytological evidence of prostate cancer was detected during the study period. These data suggest that hyperplasia, but not cancer, is frequent in acromegalic men, and that the GH-IGF axis and age are independently associated with the development of this process.     

经直肠超声引导下6+X点前列腺穿刺活检术292例的临床应用分析

目的：分析经直肠超声引导下6＋X点前列腺穿刺活检术的操作技巧及临床应用价值。方法超声引导下对292例患者行前列腺穿刺活检术,统计术后并发症。292例患者中,前列腺癌122例,前列腺良性增生106例,增生并慢性前列腺炎症28例,前列腺增生伴上皮内肿瘤18例,前列腺不典型增生15例,前列腺结核2例,非特异性肉芽肿性前列腺炎1例。结果采用6＋X 点穿刺活检术,前列腺癌阳性率为41.78％,平均穿刺针数6＋1.73。术后并发症：血尿43例,血便25例,发热20例,少量出血20例,腰痛16例,尿痛14例,排尿不.11例,大出血1例。结论经直肠超声引导下6＋X点前列腺穿刺活检术操作方便,时间短暂,并发症少,前列腺癌检出率高,有助于早期前列腺癌的诊断及鉴别诊断。     

Prostatic inflammation in benign prostatic hyperplasia - the third component?

The etiology, diagnosis, therapy and treatment outcome of the two most common nonmalignant disease of the prostate remain problematic. Benign prostatic hyperplasia and prostatic inflammation can coexist yet these conditions have been studied in almost complete isolation. The author develops the hypothesis that prostatic inflammation (prostatitis) can influence the clinical presentation and perhaps surgical outcome in patients treated for symptomatic benign prostatic hyperplasia.     

High Rates of Prostate-specific Antigen Testing in Men with Evidence of Benign Prostatic Hyperplasia

Purpose: Benign prostatic hyperplasia is common among men who may be candidates for prostate cancer screening using prostate-specific antigen (PSA) testing. Patterns of PSA testing among men with evidence of benign prostatic hyperplasia have not been studied.Methods: We examined the prevalence and correlates of a self-reported history of PSA testing. In 1994, 33,028 US health professionals without prostate cancer aged 47 to 85 years provided information on prior PSA testing, lower urinary tract symptoms characteristic of benign prostatic hyperplasia, history of prostatectomy, and prostate cancer risk factors. In 1995, a subset of 7,070 men provided additional information on diagnosis and treatment of benign prostatic hyperplasia.Results: From 39% of men in their 50s to 53% of men in their 80s reported PSA testing in the prior year (P <0.0001 for trend with age). Men were more likely to report PSA testing if they had lower urinary tract symptoms characteristic of benign prostatic hyperplasia (age-adjusted odds ratio for severe symptoms 2.2, 95% confidence interval 1.8 to 2.6), a prior history of prostatectomy (age-adjusted odds ratio 1.1, 95% confidence interval 1.02 to 1.2), or a physician diagnosis of benign prostatic hyperplasia (odds ratio 1.9, 95% confidence interval 1.7 to 2.2; adjusted for age, signs or symptoms of benign prostatic hyperplasia, and prostate cancer risk factors).Conclusions: These US health professionals reported preferential use of PSA testing among men least likely to benefit from early cancer detection (older men) and among men most likely to have a false-positive PSA result (men with benign prostatic hyperplasia). Physician and patient education are needed to promote more rational and selective use of this screening test.     

良性前列腺增生症与部分代谢因素相关性概述

良性前列腺增生症是老年男性常见疾病。目前流行病学研究证明良性前列腺增生症发生率除随年龄增长而增加外，随经济发展增长，有城乡差别，提示其与代谢因素相关。有学者提出良性前列腺增生症亦应作为代谢综合征一个组分的“代谢综合征假说”。     

良性前列腺增生患者长期联合药物治疗的临床观察

目的 观察非那雄胺联合特拉唑嗪治疗老年良性前列腺增生(BPH)的疗效.方法 对2002年6月到2010年12月我院53例老年BPH患者,连续服用非那雄胺(5 mg/d)和特拉唑嗪(2 mg/d)治疗进行临床观察,记录治疗前、治疗后2年、5年患者IPSS评分、夜尿次数、前列腺体积、膀胱残余尿量的变化.结果 治疗后患者IPSS评分、夜尿次数、前列腺体积、膀胱残余尿量疗效明显优于治疗前(P＜0.05),治疗5年后患者IPSS评分、夜尿次数、前列腺体积优于治疗2年后(P＜0.05),而治疗5年后患者膀胱残余尿量与患者治疗2年后无差别.结论 长期服用非那雄胺和特拉唑嗪治疗老年BPH患者疗效确切,且未出现明显不良反应.