中国11城市老年科门诊良性前列腺增生现状调查

目的 了解中国老年科门诊伴有下尿路症状的良性前列腺增生(LUTS/BPH)患者的诊断及治疗现状,以及患者对于这一疾病的认知及需求. 方法 2008年2～9月在全国11个城市的34个老年科门诊进行调查.先对在调查时间内前来老年科门诊就诊的全部男性患者进行LUTS/BPH病史的询问.然后在LUTS/BPH患者中选择部分患者进行详细的问卷调查及BPH相关检查.结果 在调查过程中,共有31 371位男性患者来老年科门诊就诊,14 748(47.0%)例有LUTS/BPH病史.其中10 678例(72.4%)曾接受或正在接受药物或手术治疗,4070例(27.6%)第1次诊断LUTS/BPH或以往曾诊断LUTS/BPH但未行药物或手术治疗.患者最常接受的检查是尿常规检查.血清前列腺特异抗原(PSA)检查和经腹前列腺超声检查.在接受药物治疗情况调查的3542例患者中,1155例(32.6%)采用5α还原酶抑制剂单独药物治疗,1239例(35.0%)采用5α还原酶抑制剂+α受体阻滞剂联合药物治疗.对检查及治疗满意的患者分别为1796例(84.5%)和1678例(79.0%). 结论 LUTS/BPH是老年科门诊常见疾病,目前临床应用的检查及药物治疗方案与国际上有一定差异,需要对患者进行相关疾病知识的普及.

Status investigation of benign prostatic hyperplasia in outpatient department for elderly patients in 11 Chinese cities

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia (BPH) (LUTS/BPH) in outpatient department for elderly patients, and to understand the patients' attitude and knowledge on the disease. Methods The investigation was conducted in 34 outpatient departments for elderly patients located in 11 cities from February to September 2008. The male patients who came to the clinic during the survey time were investigated whether they had LUTS /BPH history or not. Then some eligible patients were chosen to accept a more detailed questionnaire and BPH-related examinations. Results There were 31371 male patients who came to the clinic. 47.0% of them (14748 cases) had the history of LUTS / BPH, and 72.4 % (10678 cases) had medical or surgical treatments presently or previously, whereas 27.6% were untreated. The three most commonly performed examinations in clinical practice were urinalysis, prostate specific antigen (PSA) and transabdominal ultrasonography. In 3542 patients receiving medical investigation, 32.6% (1155 cases) were given 5a reductase inhibitor, and 35.0% (1239 cases) received a combination therapy of 5a reductase inhibitor plus a receptor blocker. 84.5 (1796 cases) and 79.0% (1678 cases) of all the patients were satisfied with the examinations and treatments respectively. Conclusions LUTS and BPH are common in outpatient department for elderly patients. There are discrepancies of examinations and medical treatments between real medical practice and international suggestion, and the patients' understanding of the disease should be improved