北京50岁及以上男性夜尿患病率调查

目的调查北京地区50岁及以上男性夜尿患病现状及其与年龄、下尿路症状及膀胱过度活动症(OAB)的相关性。方法采用分层多阶段整群不等比例随机抽样方法选择年龄≥50岁男性作为研究对象。下尿路症状的评估包括国际前列腺症状评分(IPSS)、生活质量(QOL)评分、腹部超声前列腺体积、残余尿量测定和最大尿流率测定。夜尿定义为夜间睡眠过程中≥2次排尿。结果本研究共调查社区中老年男性人群1656人,符合本研究要求的共计1639人。年龄50～89岁,平均(64±10)岁。夜尿的患病率为66.4%(1089/1639)。夜尿的患病率与社区中老年男性的年龄、IPSS评分、QOL评分、残余尿量以及最大尿流率均具有显著相关性(P<0.01)。对年龄以及IPSS评分的分层研究发现,夜尿的患病率随着年龄的增加以及下尿路症状的加重明显升高(P<0.01)。夜尿人群中OAB患病率显著高于非夜尿人群。结论社区中老年男性夜尿的患病率很高,严重影响中老年患者生活质量,是一种常见但未被充分认识的疾病。中老年男性夜尿患病率随年龄增长逐渐增加。     

前列腺增生下尿路症状、尿流率和前列腺体积的相关性分析

目的 了解前列腺增生患者下尿路症状、尿流率与前列腺体积之间的相关性.方法 采用SPSS 10.0软件总结并分析下尿路症状、尿流率与前列腺体积之间关系.结果 IPSS评分与最大尿流率呈负中度相关;IPSS评分与前列腺总体积、移行区体积呈弱相关.前列腺总体积、移行区体积与最大尿流率呈负弱相关.结论 BPH患者下尿路症状越严重,最大尿流率越小、前列腺体积越大;前列腺体积越大,最大尿流率越小.     

应用MRI测量的前列腺形态学参数与男性下尿路梗阻程度的相关性研究

目的应用MRI定量研究尿道前列腺部长度(UL)、前列腺总体积(PV)、中央带体积(CV)和中央带体积指数(CVI),探讨前列腺形态学参数与男性下尿路梗阻程度间的相关性.方法 62例除外神经、内分泌系统病史和尿路外伤史的男性下尿路梗阻患者行前列腺MRI和尿流动力学检查.根据最大尿流率(MFR)进行分组,即正常组(Ⅰ)、可疑梗阻组(Ⅱ)、梗阻组(Ⅲ)三组.盲法观察、测量和计算前列腺形态学参数,对患者的年龄、前列腺形态学参数及尿流动力学参数进行统计学分析.结果本组研究对象的UL、PV、CV、CVI与年龄无明显相关,MFR和年龄呈中等程度负线性相关,相关系数r=-0.409, P=0.001;三组患者的年龄、PV无显著性差异;UL、CV、CVI在Ⅰ组和Ⅲ组间存在显著差异,而在Ⅰ组和Ⅱ组、Ⅱ组和Ⅲ组间则无显著性差异; UL、CVI与梗阻程度相关,偏相关系数B分别为0.178和1.025,t值分别为2.325和2.131,P值均<0.05.结论 UL和CVI在正常组和梗阻组之间存在显著性差异,两者可作为预测下尿路梗阻程度的相关形态学参数.     

中老年男性人群代谢综合征和良性前列腺增生的相关性分析

目的 探讨中老年男性人群代谢综合征与良性前列腺增生（BPH）的相关性。方法 选择2008年5月至2013年7月于本院体检中心体检的中老年男性（≥50岁）共151例,检查一般项目包括年龄、身高、体质量、血压、既往史、国际前列腺症状评分表（IPSS）评分等。实验室检查包括空腹血糖、血脂、前列腺特异性抗原（PSA）等。影像学检查包括经直肠超声,并以此测量前列腺的体积;同时测量尿流率（Q M ax ）。利用以上指标比较代谢综合征组和非代谢综合征组BPH患病率;同时比较代谢综合征组内各因素与BPH的相关性。结果 依据检查结果分为代谢综合征组（37例）和非代谢综合征组（114例）。代谢综合征组及非代谢综合征组BPH的发病率分别为32．4％（12／37）和12．3％（14／114）。两组之间相比IPSS、前列腺体积和血清PSA差异有统计学意义（ P ＜0．05）,QMax差异无统计学意义（ P＝0．071）。肥胖、高脂血症和糖尿病是BPH的危险因素（OR值分别为1．72、3．31和2．07,P值分别为0．042、0．029和0．046）。结论 代谢综合征检查者的BPH患病率较高,主要影响BPH患者的IPSS、前列腺体积和PSA。肥胖、高脂血症、糖尿病是BPH的危险因素。     

非那雄胺联合α-受体阻滞剂治疗前列腺增生临床疗效观察

目的探讨非那雄胺联合α-受体阻滞剂对前列腺增生的临床治疗效果。方法根据治疗方法将198例前列腺增生患者分为A组(非那雄胺治疗组,n=70)、B组(α1-受体阻滞剂治疗组,n=62)、C组(联合治疗组,n=66)。观察3组患者治疗24周后的IPSS评分、最大尿流率、B超测残余尿量及前列腺体积。结果 A组与B组治疗后IPSS评分、最大尿流率、残余尿量及前列腺体积均无明显差异(P>0.05);与A组和B组比较,C组治疗后的最大尿流率明显增加(P<0.01),残余尿量及前列腺体积明显减小(P<0.01)。结论联合用药治疗前列腺增生效果显著。     

温宣通淋方治疗良性前列腺增生30例

目的观察温肾宣肺、活血通淋类中药配伍治疗良性前列腺增生的临床疗效。方法将60例良性前列腺增生症患者随机分为两组，治疗组30例采用温宣通淋方治疗，对照组30例给予保列治片治疗，于治疗前后行前列腺症状评分（IPSS）、生活质量评分及前列腺体积、最大尿流率、残余尿量变化比较：结果两组治疗后IPSS和生活质量评估均有明显改善，IPSS差异无显著性意义（P〉0．05）；治疗组的最大尿流率有明显改善，残余尿量明显减少，但前列腺体积缩小不明显，对照组变化均不显著，两组有显著差异（P〈0．05）。结论温宣通淋方能提高良性前列腺增生症患者最大尿流率，减少残余尿量，部分缩小前列腺体积，温肾宣肺、活血通淋法是治疗本病的有效方法。     

社区男性代谢综合征对下尿路症状影响的研究

目的探讨社区中老年男性下尿路症状与代谢综合征的相关性。方法随机选择50岁以上北京多个社区男性人群作为研究对象。下尿路症状的评估包括国际前列腺症状评分（IPSS）、生活质量（QOL）评分、腹部超声测量前列腺体积、最大尿流率测定。代谢综合征的调查包括高血压、糖尿病诊治病史的确认,以及体重指数（BMI）的算定。结果本研究共调查社区中老年男性人群1656人,符合本研究要求的共计1639人。平均年龄（64．4±9．6）岁。具有高血压、糖尿病或肥胖（BMI〉25kg／m^2）一项的人群分别为519人（31．67％）、199人（12．14％）和462人（28．19％）。同时具有上述三项诊断的代谢综合征组人群为40人（2．44％）,不具备任何一项诊断的非代谢综合征组人群为762人（46．49％）。研究结果显示代谢综合征组人群的IPSS评分以及QOL评分显著高于非代谢综合征组人群（P〈0．05）。代谢综合征单一危险因素高血压、糖尿病或肥胖主要影响70～79岁高龄男性人群的下尿路症状。结论本研究提示代谢综合征明显影响社区中老年男性人群的下尿路症状和生活质量。     

5型磷酸二酯酶在不同前列腺组织中表达及相关临床意义

目的探讨5型磷酸二酯酶在正常前列腺、良性前列腺增生组织中的表达及其临床意义。方法采用免疫组化技术检测正常前列腺组织及良性前列腺增生组织中的PDE5表达,并探讨PDE5表达与BPH患者的前列腺体积、PSA值、残余尿、年龄I、PSS、Qmax之间的关系。结果免疫组化结果显示:正常前列腺组织PDE5表达极弱,BPH中PDE5高表达。BPH组织中PDE5的表达与前列腺体积I、PSS、残余尿、PSA成正相关,但与年龄、最大尿流率无明显相关性。结论 PDE5在BPH组织中有较强表达,可能对BPH的病理生理过程产生重要作用。     

重庆市社区老年人认知功能与血压水平的关系：整群分层抽样

背景：血压对于老年人认知功能的影响目前尚无一致的结论。目的：探讨重庆地区部分社区60岁以上居民血压水平对其认知功能的影响。设计：整群分层抽样调查。地点、对象和方法：在重庆地区社区人群中采用整群分层法抽取3012名老年人进行调查。认知功能采用中文版简易智能状态量表(mini-mental state examination，MMSE)进行评定。主要观察指标：收缩压、舒张压及MMSE得分。结果：受检人群认知功能异常者发生率为11．95％；不同血压组之间的MMSE得分差异有显著意义(X^2=9．606，P=0．022)，而各组间认知功能异常率差异无显著性意义(OR=1．1450，P=0．3258)。在双变量相关分析中，收缩压和舒张压均与MMSE得分呈显著负相关(r=-0．134，P=0．003；r=-0．094，P=0．039)；按性别分层分析，仅男性收缩压与MMSE得分呈显著负相关(r=-0．145，P=0．022)。然而，经调整年龄和文化程度之后，上述差异或相关性在统计学上均无显著意义(P&;gt;0．1)。结论：血压水平和重庆市部分社区老年人认知功能之间没有明确的联系。     

良性前列腺增生症的临床与药物治疗

良性前列腺增生症 (ｂｅｎｉｇｎｐｒｏｓｔａｔｉｃｈｙｐｅｒｐｌａｓｉａ ,ＢＰＨ)为组织学的定义 ,是一种前列腺体积逐渐增大并压迫前列腺尿道部 ,造成膀胱出口梗阻而出现排尿困难 ,临床表现为下尿路症状 (尿频、尿急、排尿无力、尿流滴沥 ,需用力排尿和夜尿增多 )的疾病 ,并可出现许多并发症 (包括急性尿潴留 )。资料表明 ,35岁的男性中约 10 %发生前列腺增生 ,85岁时则高达 85 %。一般讲 ,ＢＰＨ及症状的发生率随年龄的增大而上升。但前列腺体积、最大尿流率与下尿路症状之间无明显相关性。1病因ＢＰＨ的发病机理尚不清楚 ,学说较多 ,…     

Measuring resistance index in patients with BPH and lower urinary tract symptoms

PURPOSE: To assess the correlation between resistance index (RI) measured in different zones of the prostate and other more commonly used parameters of benign prostatic hyperplasia (BPH). METHODS: Twenty-six male patients who underwent a detailed evaluation for lower urinary tract symptoms suggestive of BPH were examined with transrectal (TRUS) color Doppler sonography (CDS). The correlation between RI in various prostate zones, and various urinary flow rates, and the International Prostate Symptom Score (IPSS), and prostatic volume measured by TRUS was determined. RESULTS: No significant difference in RI was observed between right and left transition (TZ) and peripheral zones (PZ) in the prostate (P > 0.05). There was a significant correlation between mean RI and maximum urinary flow rate (Qmax) and mean RI in both zones (r = -0.48 for TZ and r = -0.39, P < 0.05 for PZ). Individual measurements in left and right TZ RI were also correlated with Qmax. There was a correlation between prostatic volume and both the right (P < 0.05, r = 0.56) and the left (P < 0.05, r = 0.58) TZ RI, respectively. CONCLUSION: Our results demonstrate the potential value of RI measurement in the evaluation of patients with lower urinary tract symptoms suggestive of BPH.     

经尿道前列腺等离子剜除术后患者前列腺体积的变化及其临床意义

目的:探讨经尿道前列腺等离子剜除术后患者前列腺体积的变化及其临床意义。方法:回顾分析2010年1月至2013年12月于复旦大学附属中山医院青浦分院接受手术治疗的120例前列腺增生患者的临床资料。根据手术方式,将120例患者分为经尿道前列腺等离子剜除术(plasmakinetic transurethral enucleation of prostate,PKEP)组和经耻骨上前列腺摘除术(supra public prostatectomy,SPP)组。比较两组患者手术前后的前列腺体积、最大尿流率(Qmax)、残余尿(RU)以及国际前列腺症状评分(international prostate symptom score,IPSS)。结果:两组患者术后前列腺CT表现接近,均可看到手术达到前列腺外科包膜层面。术前SPP组患者的前列腺体积明显大于PKEP组(P0.05)。两组患者术后前列腺体积均较术前明显减小,差异有统计学意义(P0.05),但两组患者术后前列腺体积差异无统计学意义。PKEP和SPP术后残留前列腺的体积均约占术前体积的26%,且主要为外科包膜。术后1个月,两组患者Qmax、RU和IPSS等疗效指标均较术前明显改善(P0.05),但两组间差异无统计学意义。结论:以外科包膜为界进行经尿道前列腺手术可以有效解除前列腺增生患者的下尿路梗阻症状,且安全性高。     

前列腺特异抗原和经直肠超声引导前列腺穿刺活检对前列腺癌的诊断价值

目的 探讨前列腺声像图特点、血清前列腺特异抗原(PSA)水平在前列腺癌诊断中的价值.方法 分析47例经直肠超声引导系统6点加目的 性穿刺患者前列腺声像图特点及临床资料,其中前列腺癌组17例,前列腺增生组30例.结果 前列腺癌组与前列腺增生组异常血流信号发现率分别为88.2%、36.7%,差异有统计学意义(P <0.05);两组异常回声结节发生率和前列腺体积的差异无统计学意义(P >0.05).游离前列腺特导性抗原(FPSA )、前列腺特导性抗原密度(PSAD)、FPSA/总前列腺特异抗原(TPSA)对前列腺癌诊断的ROC曲线面积分别为0.692、0.739、0.214.以PSAD≥0.15 μg/ml·cm3诊断前列腺癌的阳性预测值为50%,敏感性为76.5%,特异性为56.7%.结论 异常血流分布较低回声结节更具有特征性的前列腺癌超声表现,其指导目的 性穿刺的准确率较高,PSAD是较TPSA及FPSA/TPSA更有价值的前列腺癌预测指标.     

Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients

ObjectiveTo assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia.MethodsTwenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level.ResultsSelective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%.ConclusionsPAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.     

Prostate-specific antigen and prostate gland volume: correlation and clinical application.

We studied 103 patients seen in our Prostate Cancer Detection Clinic to determine whether a correlation exists between serum prostate-specific antigen (PSA) values and ultrasound-calculated prostate gland volume. Seventy men (68%) had a PSA value less than or equal to 4 ng/ml (our upper limit of normal). The men were subclassified by prostate gland volume at arbitrary break points. Twenty-five men (24%) had a prostate gland volume less than or equal to 25 cm3; in 96%, the PSA value was less than or equal to 4 mg/ml. Further analysis revealed that the percentage of men with a normal serum PSA value decreased as the prostate gland volume increased; 65.6% of the group with a gland volume between 25 and 50 cm3 (40 of 61) and 35.5% of the group whose prostate volume exceeded 50 cm3 (6 of 17) had PSA values less than or equal to 4 ng/ml. Four men had PSA values greater than 20 ng/ml; all had prostate cancer. Cancer was diagnosed in four additional patients, three with PSA values between 5 and 10 ng/ml and one with a PSA value less than 4 ng/ml. There appears to be a direct relationship between prostate gland volume and PSA value, as well as a cancer value threshold. The clinical implications of these findings are discussed.     

良性前列腺增生经直肠灰阶超声造影的初步体会

目的观察良性前列腺增生（BPH）经直肠灰阶超声造影特征。方法对经直肠穿刺活检证实为BPH的62例患者行经直肠灰阶超声造影（CETRUS）,观察分析前列腺内、外腺超声造影特征,及各造影参数与患者年龄、血清PSA水平、前列腺体积、移行区体积、移行区指数的相关性。结果BPH患者内腺造影峰值强度显著高于外腺（t=-17.295,P=0.000）;内腺超声造影开始增强时间及到达峰值强度所需时间均明显早于外腺（P〈0.01）。内、外腺各造影参数与患者年龄、血清PSA水平、前列腺体积、移行区体积、移行区指数均不具相关性（P〉0.05）。结论BPH患者前列腺内、外腺呈现显著不同的超声造影特征。     

Clinical and safety profiles of bipolar transurethral vaporization of the prostate in saline: a preliminary report

Transurethral vaporization of the prostate in saline (TURisV) is an innovative endoscopic surgical modality for the treatment of benign prostatic hyperplasia (BPH) that vaporizes prostate tissue using a uniquely designed mushroom electrode. TURisV promises instant hemostatic tissue ablation under saline irrigation and offers clinical advantages for endoscopic BPH operations. From July 2008 to February 2009, TURisV was performed in 17 cases with clinically significant BPH. Median operation time was 127.0 min and median volume of vaporized prostate tissue was 41.1 g. Median International Prostate Symptom Score improved from 20 to 4 after 12 months. Median maximum flow rate increased from 5.3 mL/s to 13.8 mL/s after 12 months. Postoperative median residual urine improved from 48.0 mL to 7.0 mL after 12 months. No changes in hemoglobin or electrolyte levels were seen postoperatively. Our results suggest that TURisV is a safe and efficacious treatment for BPH.     

125I微粒子植入术联合内分泌治疗局部晚期前列腺癌(附14例报告)

目的探讨放射性微粒子植入术联合内分泌治疗局部晚期前列腺癌。方法回顾14例局部晚期前列腺癌患者,术前经直肠超声(TRUS)确定前列腺体积,描绘前列腺的轮廓和横断面,运用三维治疗计划系统制定放射治疗方案,在TRUS引导下,植入放射性粒子125I。结果14例患者随访18～24月,治疗后PSA值、前列腺体积、IPSS评分均较术前有明显改善(P<0.05),一例出现放射性直肠炎并发症,经中药保留灌肠治疗后好转。结论TRUS引导下125I粒子植入联合内分泌治疗是治疗晚期局部前列腺癌的一种可行的方法,有较好的疗效。     

Pressure-flow studies in man during atrial fibrillation

In 13 patients who had atrial fibrillation the ascending aortic pressure-flow relationships were measured by the pressure gradient technique. Both the pressure and flow curves were similar in contour to ones previously obtained by this method. From these recordings, relationships between the phases of systole, the ventricular filling time, and various derived parameters of pressure and flow such as the pulse pressure, stroke volume, peak flow, stroke work, and peak power were evaluated. For stroke volumes greater than 15 cm(3) there was little change in the duration of systole in an individual patient. In each patient both the preejection period and the duration of ejection showed a good correlation with stroke volume, peak flow, stroke work, and peak power. When data from all patients were examined, the relationship between stroke volume and duration of ejection was found to be curvilinear and had an overall correlation of r=0.91. There was marked variation from patient to patient in duration of both the preejection period and systole. Similar correlations between the phases of systole were noted with peak flow, peak power, and stroke work. A positive but mediocre correlation was found between the previous RR interval (an index of ventricular filling time) and the subsequent stroke volume. The correlation, in six patients, between two previous RR intervals and stroke volume was considerably better. The relationship between the pulse pressure and stroke volume was reasonably close except in one patient; however, the group correlation was poor due to differences between individuals.     

Interest in genetic prostate cancer susceptibility testing among african American men

Six regions for prostate cancer genes have been identified, and it is anticipated that prostate cancer susceptibility testing will be available in the future. This correlational study identified predictors for interest in prostate cancer susceptibility testing among African American men. Participants were 320 African American men from the African American Hereditary Prostate Cancer Study and the South Carolina Prostate Cancer Education and Screening Study participated. Two questions measured interest in genetic prostate cancer susceptibility testing and family history of prostate cancer. Chi-square analyses by family history as well as demographics (age, education, marital status) were performed. Most of the men (277 [87%]) indicated an interest in genetic prostate cancer susceptibility testing. Interest in undergoing testing did not vary by family history, age, or education. Marital status was the only significant demographic predictor. Men who were married were significantly more likely to respond with a "yes" to interest in prostate cancer susceptibility testing than were men who were not married. The high "yes" response rate and the men's confusion between the genetic prostate cancer susceptibility testing and prostate cancer screening highlight the need for public education once prostate cancer genes are identified and available for public testing.