蛋白质摄入量与良性前列腺增生相关性分析

目的 检验膳食蛋白质、牛奶及奶类制品与良性前列腺增生(BPH)的关系。方法 采用病例对照研究方法,病例为2007-2009年施行BPH手术,年龄在55～90岁的360例男性;对照为与病例年龄相同的360例患其他疾病的男性,对研究对象进行问卷调查,同时用半定量化食物频率调查表(FFQ),调查研究对象膳食情况;采用多元Logistic回归模型检验研究因素与BPH关系的比值比(OR)及其相应的95%可信区间(CI)。结果 病例组居住农村者高于对照组,分别为28.3%(102/360)和16.7%(60/360),2组间差异有统计学意义(P<0.05);在调整了年龄及热能的摄入量后,总蛋白质的摄入量与BPH呈负相关(χ²=8.567,P=0.036);与摄入量最低四分位数对照组比较,病例组最高四分位数者的OR值明显降低(OR=0.615,95%CI=0.014～0.930);动物性蛋白质、牛奶及奶类制品的摄入量与BPH呈负相关关系(分别为χ²=10.572,P=0.014和OR=0.731,95%CI=0.545～0.981),但随着每日摄入量的增加,BPH发病的危险性并不呈一致性的降低,与摄入量最低四分位数的对照组比较,病例组最高四分位数者的OR值增加(分别为OR=0.638,95%CI=0.418～0.972和OR=0.636,95%CI=0.292～0.835)。结论 膳食蛋白质,尤其是动物性蛋白质可使BPH的危险性降低,而摄入过多动物蛋白却使这种保护性作用降低。     

高血压、体质指数与良性前列腺增生关系

目的 探讨高血压、体质指数(BMI)与临床术后良性前列腺增生(BPH)的关系.方法 采用病例对照研究方法,病例为55～90岁临床诊断为BPH、施行手术治疗、术后病理证实为BPH的患者;对照为同期住院的非前列腺增生患者,年龄与病例相同;病例与对照各380例,以1:1匹配;采用自行设计的调查表对研究对象进行调查,内容包括一般情况、身体测量、生活方式、既往史以及BPH家族史等,采用Logistic回归模型计算OR值及其相应的95%C1.结果 调整年龄因素后,与收缩压正常者(＜140 mmHg),(1 mmHg=O.133 3 kPa)相比较,收缩压160-179mmHg者和收缩压≥180 mmHg者发生BPH的危险性明显增加(分别为OR=2.135,95%CI=1.139～4.001和OR=2.704,95%CI=1.475-4.958);高血压病程与BPH呈正相关(x2=8.876,P=0.031),病程≥20年组发生BPH的危险性明显增加(OR=4.984,95%a=2.006-12.203,P=0.001).与非高血压者比较,超重或肥胖者罹患高血压发生BPH的危险性明显地增高(OR=2.548,95%CI=1.397-4.648和OR=2.667,95%CI=1.038-13.212).结论 高血压是BPH发病的危险因素;长期罹患高血压、尤其是高收缩压状态能够促进BPH的发生和发展;超重和肥胖的男性高血压BPH的危险性明显增加.     

Dioxin exposure and benign prostatic hyperplasia

OBJECTIVE: Dioxins decrease prostate weight, reduce androgen responsiveness, and inhibit prostate morphogenesis in rats. We assessed the association of dioxins and benign prostatic hyperplasia (BPH) in participants in the National Health and Nutritional Examination Survey 1999-2000. METHODS: Forty-two participants were classified as having BPH and 99 were classified as controls. Dioxin exposure was expressed as dioxin toxic equivalents (TEQ). Age, body mass index, waist circumference, race/ethnicity, smoking, physical activity, and education were assessed as potential confounders. RESULTS: After age adjustment, men without BPH had 20.9% higher TEQs (95% confidence interval [CI] = 5.4-38.7%) as compared with men with BPH. On weighted, multivariate, logistic regression analyses, men with higher dioxin levels had lower odds of having BPH (odds ratio = 0.22, 95% CI = 0.08-0.62). CONCLUSIONS: Dioxin exposure in the general population may be associated with decreased odds of BPH. Our study findings need to be confirmed.     

Association between air pollution and benign prostatic hyperplasia: An ecological study

Benign prostate hyperplasia (BPH) is a prevalent medical condition; however, little is known about the effect of environmental factors. Therefore, we conducted surveys to examine the association between air pollution and the risk of BPH in South Korea between May 2010 and April 2013, yielding data for 1,734 men. Air pollution information was obtained from the National Air Pollutants Emission 2010 report. Logistic regression analyses were conducted after adjusting for potential confounders. The International Prostate Symptom Score significantly increased with increasing per capita air pollutant emissions. The risk of BPH increased as the overall concentration of air pollutants increased (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.55–3.21). In particular, nitrogen oxides (OR, 1.73; 95% CI, 1.25–2.39) and sulfur oxides (OR, 2.02; 95% CI, 1.42–2.88) showed a dose-dependent association. Our findings support a positive association between the risk of BPH and air pollution.     

Association of anthropometric measures with the presence and progression of benign prostatic hyperplasia

The authors investigated the association of anthropometric measures with the presence and progression of components of benign prostatic hyperplasia (BPH) and a clinical outcome of BPH in a cohort of healthy, Caucasian men aged 40-79 years that was randomly selected from the Olmsted County, Minnesota, population beginning in 1990. Exclusionary criteria included prostate or bladder surgery, urethral surgery or stricture, or medical or other neurologic conditions that could affect normal urinary function. Height, weight, and waist and hip circumferences were measured. Components of BPH, including American Urological Association Symptom Index scores, peak urinary flow rate, and prostate volume, were assessed on a randomly selected subsample. Acute urinary retention was assessed through review of community medical records. There were few significant associations of anthropometric measures with the presence or progression of components of BPH or clinical outcome of BPH, and there were no instances where the point estimates for the BPH components suggested a dose-response effect. The authors conclude that anthropometric measures are not significantly associated with the presence or progression of BPH as measured by American Urological Association Symptom Index scores, peak urinary flow rate, prostate volume, or acute urinary retention. These data provide no evidence of a consistent significant relation between anthropometric measures and BPH.     

Conservative treatment of benign prostatic hyperplasia

Medical treatment of benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts is recommended in initial phase. Prostate volume is decreased and mechanical component of dysuria is improved by treating for a long time (months, years) with 5-alpha-reductase finasteride which contains hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with alpha-receptor blockers which act on the bladder neck. These medicines have effects earlier and are recommended for all patients with benign prostatic hyperplasia independently of prostate volume. These might have some side effects like hypotension. The improving effects of 5-phosphodiesterase inhibitors on BPH have been discovered recently. The same effect has been described of alpha-blockers on sexual activity.     

Pharmacologic treatment of benign prostatic hyperplasia

Medical treatment for benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts are recommended in initial phase. Effectiveness of these drugs are approved by some placebo controlled double blind studies. However effectiveness of these are not as good as medical drugs'. It is well known that they have no side effects and are cheaper than medicines. Prostate volume is decreased and mechanical component of dysuria is improved by treating for long time (months, years) with 5 alfa reductase finasterid which contain hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with a receptor blockers which act on the bladder neck. These medicines effect earlier and are recommended for all benign prostatic hyperplasia patients independently of prostate volume. These might have some side effect like hypotension.     

良性前列腺增生与吸烟、体质指数关系

目的应用病例对照研究方法,对临床前列腺增生（BPH）手术病例进行调查,以研究吸烟、体质指数与良性前列腺增生危险性之间的关系。方法病例组为2004～2006年施行良性前列腺增生手术,年龄在50～82岁的343名男性;对照组为与病例年龄相同的361名患其他疾病的男性。采用自行设计的调查表对住院期间研究对象进行调查,内容包括人口学特征、身体测量、生活方式（吸烟、膳食情况）、个体疾病既往史以及家族一级亲属前列腺疾病史等。采用多元回归模型测量各因素与BPH关系的比值比（OR）及其相应的95%CI。结果控制了年龄和体质指数后,每天吸烟1～29支与发生BPH的危险性无关,OR=0.97,95%CI=0.68～1.46,P〉0.05。但每天吸烟≥30支与不吸烟者比较,发生BPH的危险性增加,OR=1.32,95%CI=0.92～2.58,P〈0.01。超重者（BMI24.0～27.9）或肥胖者（BMI≥28）吸烟与发生BPH的危险性显著地增高,与不吸烟者比较分别为：OR=1.68,95%CI=1.32～3.67和OR=2.35,95%CI=1.83～4.16。结论只有现行吸烟≥30支/d的男性才与BPH呈正相关,超重和肥胖的男性吸烟发生临床BPH的危险性显著地升高。     

Clinical features and management of benign prostatic hyperplasia

Benign prostatic hyperplasia represents the most common benign neoplastic condition afflicting men and has a major impact on the health of the population. It refers to a regional and nodular growth of stromal proliferation which, because of its proximity to the urethra, causes varying degrees of bladder outflow obstruction.     

男性饮酒及体质指数与良性前列腺增生关系

目的 探讨饮酒、体质指数与良性前列腺增生(BPH)的关系。方法 采用病例对照研究方法。病例为2004~2006年临床诊断为良性前列腺增生、施行手术治疗、术后病理证实为BPH的患者,年龄为56~88岁。对照为同期住院的非前列腺增生患者,年龄与病例相同。以1:1匹配。病例与对照各334例,采用自行设计的调查表对研究对象进行调查。内容包括一般情况、身体测量、生活方式(吸烟、饮食、饮酒情况等)、既往史以及前列腺疾病的家族史等。采用Logistic回归模型计算OR值和95%CI。结果 病例组脑力劳动者所占的比例高于对照组,但其所从事的职业性活动却低于对照组,二者差异有统计学意义(χ²=4.446,P<0.05)。与不饮酒者比较,每天酒精摄入量为31~45 g者其OR=0.652,95%CI=0.484~0.878;洒精摄入量为46~60 g/d者其OR=0.533,95%CI=0.307~0.924。但重度饮酒者这种相关性减弱,酒精摄入量>60 g/d者与不饮酒者比,OR值增大,OR=0.623,95%CI=0.438~0.886。结论 酒精摄入量与BPH危险性间呈U型关系,而饮酒的年限、体重指数与BPH发病无关系。适量饮酒(酒精摄入量≤60 g/d)可能是BPH发病的保护因素。     

Cost-effective monotherapy of concomitant benign prostatic hyperplasia and hypertension

Increasing longevity in the developed world means an increasing prevalence of age-related disorders such as hypertension and benign prostatic hyperplasia (BPH). In the case of BPH there are additional factors contributing to the increasing number of patients requiring treatment. This review illustrates the potential economic and effectiveness benefits of using one drug to treat two disorders.     

Questioning questions about symptoms of benign prostatic hyperplasia

OBJECTIVES: Our aim was to conduct a survey about urinary symptoms and to find out if questioning patients about symptoms is helpful for the GP to make medical decisions concerning prostate problems among middle-aged men. METHODS: Twelve hundred randomly chosen men aged 55--65 years from the general population in north-west Stockholm, Sweden were sent a questionnaire consisting of symptom questions focusing on prostate problems based on the International Prostate Symptom Score (I-PSS). A subset of 120 respondents were asked to answer the same questions again and to participate in a urological examination including urodynamics and ultrasonography. The main outcome measures were the prevalence of urinary symptoms and the relationship between the symptom score and objective measures. RESULTS: A response rate of 86% was obtained in the questionnaire study. Twenty-one per cent of the respondents stated that they had general problems related to urination. Among individual symptoms, post-void dribbling and a weak stream were most common. Among the men examined at the Urological Department, the average prostatic volume was found to be 40 cm(3). Three out of four were assessed to have infravesical obstruction. No correlation between subjective symptoms and objective measurements of either a statistical or clinical significance was found. CONCLUSIONS: Urinary symptoms are common among middle-aged men. Further, an enlarged prostate and/or infravesical obstruction is often found in the ageing man. Information obtained by asking prostate-specific symptom questions cannot, however, serve as the foundation for the GP to find those men whose problems would be solved by actions directed at the prostate.     

保留尿道的耻骨后前列腺切除术60例临床报告

目的 探讨保留尿道的耻骨后前列腺切除术治疗良性前列腺增生症的临床疗效.方法 对60例慢性前列腺增生症患者采用保留尿道的耻骨后前列腺切除术进行治疗.结果 手术时间60～140 min,平均80 min.术中出血60～140 ml,平均100 ml,未输血.术后住院8～15 d,平均9 d.术后随访1～5年,疗效优25例（41.7%）,良32例（53.3%）.结论 保留尿道的耻骨后前列腺切除术治疗慢性前列腺增生症效果良好,无远期并发症发生.     

膀胱癌合并前列腺增生同期行经尿道等离子电切术

目的:非肌层浸润性膀胱癌合并前列腺增生同期行经尿道等离子电切术治疗的临床效果.方法:所选研究对象为医院收治的非肌层浸润性膀胱癌合并前列腺增生患者,年限为2015年1月-2017年1月,符合标准的有21例.所有患者均实施等离子膀胱肿瘤切除术联合经尿道等离子电切术同期治疗.患者及家属均知情同意,比较治疗前后患者的前列腺症状改善情况.结果:治疗后,患者最大尿流率、残余尿量、国际前列腺症状评分均优于治疗前,差异有统计学意义(P<0.05);患者均顺利完成手术,均痊愈出院,术中均未出现相关并发症;术后随访12个月,所有患者均未出现严重并发症,且无复发.结论:在非肌层浸润性膀胱癌合并前列腺增生患者治疗中,同期行经尿道等离子电切术治疗的效果理想,值得进行深入研究和推广.     

前列佳胶囊对前列腺增生症的干预效果研究

[目的]对前列佳胶囊干预前列腺增生症患者的效果进行评价。[方法]采用随机平行对照试验方法,选择102例前列腺增生症(BPH)患者,随机分为干预组(54例)和对照组(48例),干预组患者服用前列佳胶囊,对照组患者服用安慰剂,疗程12周。[结果]干预后患者国际前列腺症状评分(IPSS)、最大尿流率(MFR)、生活质量评分(QOL)及夜尿次数与干预前比较,均有明显改善(P均<0.01)。干预前后对比,两组患者的前列腺体积均有缩小(P<0.01)。干预后,干预组最大尿流率上升,对照组则下降,差异有统计学意义(P<0.01)。前列佳胶囊改善最大尿流率的作用,主要表现在中、轻度前列腺增生症患者,而对于重度前列腺增生症患者的影响不明显。[结论]前列佳胶囊在改善患者排尿困难症状、减少夜尿次数和提高尿流率等方面有肯定的效果。