α1受体阻滞剂联合抗生素治疗慢性前列腺炎疗效及机制

目的 :观察α1受体阻滞剂联合抗生素治疗慢性前列腺炎 (CP)的疗效 ,初步探讨α1受体阻滞剂缓解CP症状的机制。　方法 :将 80例CP患者随机分成 2组 ,每组 4 0例 :治疗组口服特拉唑嗪 2mg及左旋氧氟沙星 0 .2g ,每日 2次 ;对照组仅口服左旋氧氟沙星 0 .2g ,每日 2次。治疗 6周 ,观察治疗前后慢性前列腺炎症状指数评分 (NIH CPSI)、前列腺按摩液常规及尿流动力学指标的变化。　结果 :治疗组NIH CPSI由治疗前 (31.8± 7.4 )分降至 (15 .5± 6 .6 )分 ,对照组NIH CPSI由治疗前 (30 .9± 7.1)分降至 (2 1.4± 6 .2 )分 ,治疗组改善程度较对照组更为显著 (P <0 .0 5 )。治疗组治疗前后最大尿流率 (MFR)分别为 (16 .5± 6 .3)ml/s和 (2 0 .4± 4 .6 )ml/s,两者差异有显著性 (P <0 .0 5 ) ;治疗组治疗前后最大尿道压 (MUP)分别为 (92 .5± 15 .3)cmH2 O和 (72 .5± 13.4 )cmH2 O ,两者差异有显著性 (P <0 .0 5 ) ;对照组治疗前后MFR分别为 (16 .1± 5 .8)ml/s和 (17.3± 6 .8)ml/s,MUP分别为 (93.2± 14 .8)cmH2 O和 (91.7± 13.6 )cmH2 O ,治疗前后差异均无显著性 (P >0 .0 5 )。　结论 :α1受体阻滞剂可降低尿道压力 ,缓解前列腺内尿液返流 ,与抗生素合用可提高疗效。

Effect and Mechanism of α1-adrenoceptor Blocker Combined with Antibiotics for Chronic Prostatitis

OBJECTIVE: To investigate the effect and mechanism of alpha1-adrenoceptor blocker combined with antibiotics in the treatment of chronic prostatitis. METHODS: Eighty patients with chronic prostatitis were divided into two groups, one treated with alpha1-adrenoceptor blocker (Terazosin 2 mg qn) and Levo-ofloxacin (0.2 bid), and the other given Levo-ofloxacin (0.2 bid) alone for 6 weeks. Chronic prostatitis symptom index (CPSI), urodynamic data and prostatic secretion examination were compared before and after treatment. RESULTS: The CPSI score of the treated group decreased from 31.8 +/- 7.4 to 15.5 +/-6.6, while that of the control group decreased from 30.9 +/- 7.1 to 21.4 +/- 6.2. There was significant difference between the two groups (P < 0.05). The maximum flow rates before and after the combined treatment were 16.5 +/- 6.3 ml/s and 20.4 +/- 4.6 ml/s, while those before and after Levo-ofloxacin administration were 16.1 +/-5.8 ml/s and 17.3 +/- 6.8 ml/s. The difference was significant (P < 0.05). The maximum urethral pressure of the combined treatment group decreased from 92.5 +/- 15.3 cm H2O to 72.5 +/- 13.4 cm H2O, while that of the control group decreased from 93.2 +/- 14.8 cm H2O to 91.7 +/- 13.6 cm H2O. CONCLUSION: Alpha1-adrenoceptor blocker can lower the intraurethral pressure, which prevents urine from refluxing to the prostate. Alpha1-adrenoceptor blocker combined with antibiotics is effective for chronic prostatitis.