中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2008年
6期
611-613
,共3页
张耀光%王建业%刘明%许进%伍建业%辛英%万奔%魏东%朱生才%曾平
張耀光%王建業%劉明%許進%伍建業%辛英%萬奔%魏東%硃生纔%曾平
장요광%왕건업%류명%허진%오건업%신영%만분%위동%주생재%증평
良性前列腺增生症%前列腺体积%残余尿%观察等待%随访
良性前列腺增生癥%前列腺體積%殘餘尿%觀察等待%隨訪
량성전렬선증생증%전렬선체적%잔여뇨%관찰등대%수방
目的 掌握观察等待治疗方案下良性前列腺增生症(BPH)患者主要临床指标的具体数据变化规律,分析影响病情进展的主要危险因素.方法 按照试验规定的纳入和排除标准,选择初诊BPH患者纳入观察等待治疗方案组,对入组患者的国际前列腺增生症症状评分(IPSS)、前列腺体积、血清前列腺特异性抗原(PSA)、最大尿流率、平均尿流率、残余尿进行24个月的随访观察.结果 IPSS、前列腺体积、PSA(ng/ml)、最大尿流率(ml/s)在基线、12个月、24个月时分别为7±4、4±3、4±3;33.0±9.0、33.8±7.6、30.9±6.8;1.53±1.35、1.43±0.95、1.22±0.99;17.1±5.0、17.2±6.1、19.2±8.0.在随访24个月时,61例观察等待的患者,除前列腺体积均数有缓慢地进展外,其他观察指标均略有好转,其中有42例(69%)患者病情进展缓慢,甚至有所好转.而随访IPSS评分均数与入组时之差值的差异有统计学意义(P＜0.0001).用logistic回归对影响病情进展的因素进行分析,结果显示只有前列腺体积(P=0.0910)、残余尿(P=0.0780)具有成为影响因素的趋势.结论 在观察等待治疗方案下,入组的BPH患者在24个月中病情进展缓慢,大部分病例不必转入其他治疗方案.对观察等待BPH患者的随访情况进行数据化分析,能够为更加合理、精确地选择BPH的干预时间和治疗方案提供有意义的数据化参考.
目的 掌握觀察等待治療方案下良性前列腺增生癥(BPH)患者主要臨床指標的具體數據變化規律,分析影響病情進展的主要危險因素.方法 按照試驗規定的納入和排除標準,選擇初診BPH患者納入觀察等待治療方案組,對入組患者的國際前列腺增生癥癥狀評分(IPSS)、前列腺體積、血清前列腺特異性抗原(PSA)、最大尿流率、平均尿流率、殘餘尿進行24箇月的隨訪觀察.結果 IPSS、前列腺體積、PSA(ng/ml)、最大尿流率(ml/s)在基線、12箇月、24箇月時分彆為7±4、4±3、4±3;33.0±9.0、33.8±7.6、30.9±6.8;1.53±1.35、1.43±0.95、1.22±0.99;17.1±5.0、17.2±6.1、19.2±8.0.在隨訪24箇月時,61例觀察等待的患者,除前列腺體積均數有緩慢地進展外,其他觀察指標均略有好轉,其中有42例(69%)患者病情進展緩慢,甚至有所好轉.而隨訪IPSS評分均數與入組時之差值的差異有統計學意義(P＜0.0001).用logistic迴歸對影響病情進展的因素進行分析,結果顯示隻有前列腺體積(P=0.0910)、殘餘尿(P=0.0780)具有成為影響因素的趨勢.結論 在觀察等待治療方案下,入組的BPH患者在24箇月中病情進展緩慢,大部分病例不必轉入其他治療方案.對觀察等待BPH患者的隨訪情況進行數據化分析,能夠為更加閤理、精確地選擇BPH的榦預時間和治療方案提供有意義的數據化參攷.
목적 장악관찰등대치료방안하량성전렬선증생증(BPH)환자주요림상지표적구체수거변화규률,분석영향병정진전적주요위험인소.방법 안조시험규정적납입화배제표준,선택초진BPH환자납입관찰등대치료방안조,대입조환자적국제전렬선증생증증상평분(IPSS)、전렬선체적、혈청전렬선특이성항원(PSA)、최대뇨류솔、평균뇨류솔、잔여뇨진행24개월적수방관찰.결과 IPSS、전렬선체적、PSA(ng/ml)、최대뇨류솔(ml/s)재기선、12개월、24개월시분별위7±4、4±3、4±3;33.0±9.0、33.8±7.6、30.9±6.8;1.53±1.35、1.43±0.95、1.22±0.99;17.1±5.0、17.2±6.1、19.2±8.0.재수방24개월시,61례관찰등대적환자,제전렬선체적균수유완만지진전외,기타관찰지표균략유호전,기중유42례(69%)환자병정진전완만,심지유소호전.이수방IPSS평분균수여입조시지차치적차이유통계학의의(P＜0.0001).용logistic회귀대영향병정진전적인소진행분석,결과현시지유전렬선체적(P=0.0910)、잔여뇨(P=0.0780)구유성위영향인소적추세.결론 재관찰등대치료방안하,입조적BPH환자재24개월중병정진전완만,대부분병례불필전입기타치료방안.대관찰등대BPH환자적수방정황진행수거화분석,능구위경가합리、정학지선택BPH적간예시간화치료방안제공유의의적수거화삼고.
Objective To analyze the changes of the main clinic parameters in patients with benign prostate hyperplasia (BPH) treated by watchful waiting and to find out the risk factors contributing the progress of BPH. Methods According to the inclusion and exclusion criteria, 61 patients diagnosed as BPH were recruited in the group of watchful waiting. Data on IPSS, prostate volume, prostate specific antigen(PSA), maxium flow rate, average flow rate and residual urine volume during follow-up period of 24 months, were recorded. Results At 0, 12, 24 months, the IPSS, prostate volume (ml), PSA(ng/ml),maxium flow rate (ml/s) were 7±4, 4±3, 4±3 ; 33.0±9.0, 33.8±7.6, 30.9±6.8 ; 1.53±1.35,1.43±0.95, 1.22±0.99; 17.1±5.0, 17.2±6.1, 19.2±8.0, respectively. At the end of the 24-months follow-up, all observed parameters had a little improvement except the average prostate volume in this group. Of the 61 patients, 42(62%) progressed slowly or became better when comparing with baseline data of the study. Moreover, the difference between at 24-month and at baseline period, IPSS showed statistical significance (P＜0.0001) in t test. In the study of BPH progression risk factors by logistic regression analysis, prostate volume( P = 0. 0910) and residual urine volume( P = 0. 0780) showed a trend of becoming the risk factors. Conclusion Our study showed that patients treated with watchful waiting had slow progression and majority of these patients did not need to alter their treatment options.Through data analysis, we noticed that the changes of data watchful waiting patients could help us to choose more precise and reasonable treatment option in clinical pratice.[ Key words ] Benign prostate hyperplasia; Prostate volume; Residual urine; Watchful waiting;Follow-up
