上海市部分社区中老年男性下尿路症状与良性前列腺增生特性的调查研究

目的:调查上海市社区40～70岁中老年男性下尿路症状(LUTS)的患病率及前列腺各项参数随增龄变化的规律。方法:2009年11月至2010年6月对上海市9个居委1 000例40～70岁的常住居民,运用整群及年龄分层的流行病学随机抽样方法,通过国际前列腺症状评分(IPSS)调查该人群中LUTS的患病率;经直肠超声检测其前列腺及移行带的左右径、前后径、上下径,并拟合前列腺随年龄的生长规律。结果:在40～49岁、50～59岁和60～70岁年龄组中,中、重度LUTS(IPSS≥8)患病率分别为10.0%、15.0%和28.7%,LUTS症状随年龄增加而明显上升。超声检测显示:前列腺及其移行带的左右径、前后径、上下径和体积均随年龄增长而增大,各年龄组存在统计学意义(P<0.05);对左右径、前后径和上下径各参数值拟合生长速度方程分别为Y=1.6×10-5X3-0.002 1X2+0.074 6X+0.677 2、Y=-2.4×10-5X3+0.003 3X2-0.131 2X+1.269、Y=1.6×10-5X3-0.001 8X2+0.073X-0.690 9。显示前列腺的左右径及前后径生长速度较为均衡,在60岁以前左右径的生长速度明显快于上下径,而60岁以后上下径的生长速度迅速上升且超过左右径的速度。结论:上海市社区中老年男性LUTS患病率接近于国内外情况,前列腺各径线生长速度呈现不均衡性,60岁以前以左右径生长为主,而60岁以后则以上下径生长为主。

Lower urinary tract symptoms and prostatic growth pattern among old and middle-aged males in Shanghai community

Objective: To investigate the prevalence of lower urinary tract symptoms(LUTS) and the age-related growth pattern of the prostate among 40-70 year-old males in Shanghai community.Methods: Using cluster and stratified random sampling and IPSS,we investigated the prevalence of LUTS among 1000 males aged 40-70 years in the general population of Shanghai from November 2009 to June 2010.We measured the transverse,anteroposterior and vertical diameters of the prostate and its transition zone in each volunteer by transrectal ultrasonography and established the equation for the age-related growth pattern of the prostate.Results: In the 40 to 49-,50 to 59-and 60 to 70-year groups,the incidence rates of moderate and severe LUTS(IPSS≥8) were 10.0%,15.0% and 28.7%,respectively.The length,width,height and volume of the prostate and its transition zone were positively corrected with age(P <0.05).The prostatic growth pattern equations based on the parameters of the transverse,anteroposterior and vertical diameters were Y = 1.6 × 10-5X3-0.002 1X2 + 0.074 6X + 0.677 2,Y =-2.4 × 10-5X3 + 0.003 3X2-0.1312X + 1.269,and Y = 1.6 × 10-5X3-0.001 8X2 + 0.073X-0.690 9,respectively.The transverse and anteroposterior diameters of the prostate grew at a relatively similar rate,while the transverse diameter grew obviously faster than the vertical diameter before 60 years old,but the latter significantly increased and even exceeded the former after 60 years old.Conclusion: The prevalence of LUTS among old and middle-aged males in Shanghai community is similar to that recently reported at home and abroad.The transverse and anteroposterior diameters of the prostate grow at a relatively similar rate,but the vertical diameter increases faster after 60 years old.