安庆地区原发性高血压人群良性前列腺增生患者梗阻症状的影响因素★

背景：良性前列腺增生患者梗阻症状被认为是动力性因素和静力性因素共同引起，梗阻的动力性因素主要与前列腺和膀胱颈部平滑肌的张力有关，静力性因素主要与增大的前列腺体积压迫尿道有关。原发性高血压可导致前列腺体积增大。　 目的：分析原发性高血压人群中良性前列腺增生患者梗阻症状的各种影响因素。 设计、时间及地点：调查分析，于2005-07/2006-02在安徽省安庆市及其周边地区完成。 对象：来自于安庆及其周边地区的特拉唑嗪联合氨氯地平治疗的老年男性原发性高血压人群，选取其中的272例被诊断为良性前列腺增生的患者，年龄50~75岁。患者对调查知情同意，自愿参加本次调查。 方法：采用问卷调查、体格检查及尿动力学检查，对梗阻症状各种影响因素进行分析。 主要观察指标：国际前列腺症状评分（IPSS）、梗阻症状评分(IPSS 梗阻)、生活质量评分、最大尿流率、收缩压、舒张压以及其他一般人口学特征。 结果：高血压伴良性前列腺增生患者，梗阻症状严重程度随着年龄增加而加重；间断排尿评分随着收缩压的升高而增加，而IPSS梗阻评分、尿线变细以及排尿用力评分随着舒张压的升高而增加；体力劳动强度的增加，梗阻症状的严重程度有减轻的趋势（差异未达到显著性）；随着每天坐位时间的增加，IPSS总评分、IPSS梗阻评分及尿线变细评分随之增加；logistic逐步回归分析显示：高血压人群中良性前列腺增生梗阻症状程度受年龄、舒张压、坐位时间、饮酒、首次性生活年龄以及30岁性生活频率6种因素影响较大。 结论：①年龄、高舒张压状态、首次性生活年龄过早和30岁性生活过频是良性前列腺增生患者梗阻症状的重要影响因素。②适当的增加体力劳动和减少每天的坐位时间对减轻梗阻症状有保护作用。③饮酒可能是良性前列腺增生梗阻症状的影响因素。

Obstructive symptoms associated with benign prostatic hyperplasia in Anqing hypertension populations: Influential factor analysis

BACKGROUND: Obstructive symptoms in benign prostatic hyperplasia (BPH) patients are considered as results from dynamic factors and static factors. The dynamic factors are related to smooth muscle tension of the prostate and neck of bladder, and static factors are related to urinary tract compressed by hyperplasia prostate. In addition, hypertension can lead to increased prostate volume. OBJECTIVE: To explore influential factors for obstructive symptoms of BPH patients with hypertension. DESIGN, TIME AND SETTING: Investigation was performed at Anqing City and its surrounding areas between July 2005 and February 2006. PARTICIPANTS: 272 patients diagnosed with obstructive symptoms associated with BPH and undergoing Terazosin and Amlodipine treatment were selected from Anqing City and its surrounding areas. The patients aged 50 to 75 years, and participated voluntarily the experiment. METHODS: Questionnaire, physical examination and urodynamics examination were performed to analyze the influential factors for obstructive symptoms. MAIN OUTCOME MEASURES: International Prostate Symptom Score (IPSS), IPSS obstruction score, quality of life, maximal urinary flow rate, systolic blood pressure, diastolic blood pressure and characteristics of the general population. RESULTS: The degree of obstructive symptoms increased with the growth of the age; with the systolic blood pressure increased, intermittent voiding score increased, and with the diastolic blood pressure increased, IPSS obstruction score, urine-thinning score, and voiding force score increased; the increase in physical strength minimally reduced the severity of the obstructive symptoms. With the daily seat time increasing, IPSS total score, IPSS obstruction score and urine-thinning score increased. Logistic regression analysis showed that age, diastolic blood pressure, sitting time, drinking, the age of first sexual behavior and sexual frequency at 30 years old had a greater impact on obstructive symptoms. CONCLUSION: Age, state of high diastolic blood pressure, the age of first sexual behavior, and sexual frequency at 30 years old are important factors for obstructive symptoms associated with BPH; Appropriate increase in physical strength and reduction of daily sitting time show protective effect of obstructive symptoms. Drinking is a possible influential factor for BPH-associated obstructive symptoms.