老年良性前列腺增生症单药治疗无效的危险因素

目的通过分析α-受体阻滞剂治疗老年良性前列腺增生症(BPH)无效的危险因素,明确初诊老年BPH的药物选择。方法回顾研究96例老年BPH患者,其中单用α-受体阻滞剂坦索罗新治疗组42例,与5α-还原酶抑制剂非那雄胺联合治疗组54例,比较两组国际前列腺症状评分(IPSS)、生活质量指数(QOL)、最大尿流速(Qmax)、残余尿量(PVR)、前列腺体积及血清前列腺特异性抗原(PSA)。结果联合用药与单药治疗组比较,前列腺体积、Qmax和IPSS具有统计学差异;多元回归分析显示IPSS(P<0.001)及前列腺体积(P<0.05)与老年BPH单药治疗无效密切相关。结论老年BPH患者单药及联合治疗均能改善病情,对于初诊时具有较高的IPSS评分及严重的前列腺体积增大者应给予药物联合治疗。

Risk factor analysis of monotherapy failure in old patients with benign prostatic hyperplasia

Objective To determine the treatment of criteria for old patients with benign prostatic hyperplasia(BPH) by analyzing the risk factors causing α-blocker monotherapy failure.Methods 96 patients with BPH were enrolled,42 patients were prescribed an α-blocker tamsulosin.54 patients were combined with 5 α-reductase inhibitor finasteride.The differences between the two groups for their initial prostate volume,serum prostate-specific antigen(PSA),maximum urinary flow rate(Qmax),International Prostate Symptom Score(IPSS),and postvoid residual urine volume(PVR) were compared.Results The prostate volume(41.4 ml vs.26.3 ml),Qmax(6.3 ml/s vs.10.5 ml/s),and IPSS(23.3 vs.14.9) had significant differences(P<0.05) between the two groups.The multiple regression analysis showed the significant factors in α-blocker monotherapy failure were IPSS(P<0.001) and prostate volume(P=0.015).Conclusions Both tamsulosin alone and tamsulosin/ finasteride combination are effective in reducing the clinical symptoms of old patients with BPH.For the initial diagnosis of BPH,patients with a larger prostate volume and severe IPSS should be combined α-blocker therapy with 5-α-reductase inhibitor(5-ARI).