CAJ | 학술논문

目的探讨不同的临床因素与前列腺增生症(BPH)相关下尿路症状(LUTS)之间的关系,了解影响BPH有关LUTS的危险因素.方法对2003年7月至2009年10月收治的548例前列腺增生症患者的资料进行回顾性研究.分析不同年龄、病史、最大尿流率(Qmx)、前列腺总体积、移行区体积、移行区指数、总PSA、游总比(f/tPSA)、组织炎症对IPSS值的影响,并进行多元线性回归分析.结果年龄、移行带体积、Qmax、PSA及前列腺组织炎症对IPSS评分影响显著.随着年龄增大和移行带体积的增加,IPSS值变大；随着最大尿流率的减少,IPSS值显著增加(P＜0.05).当PSA ≥4 ng/mL时,IPSS值要显著大于＜4 ng/mL组(P＜0.05),但是介于4～10 ng/mL组和≥10 ng/mL组的IPSS评分并无差异(P＞0.05).合并前列腺组织炎症患者的IPSS值要显著高于非炎症组(P＜0.05).进一步通过多元线性回归分析,发现所有可能影响IPSS评分的因素中,Qmax和前列腺组织炎症与IPSS评分密切相关(β=-0.807,5.736;P＜0.001).结论前列腺组织炎症和Qmax对下尿路症状的影响最显著.其他的临床因素如患者年龄、移行带体积和PSA值对BPH患者的下尿路症状影响有限,经过多因素回归分析发现并无显著性.
목적 탐토불동적림상인소여전렬선증생증(BPH)상관하뇨로증상(LUTS)지간적관계,료해영향BPH유관LUTS적위험인소.방법 대2003년7월지2009년10월수치적548례전렬선증생증환자적자료진행회고성연구.분석불동년령、병사、최대뇨류솔(Qmx)、전렬선총체적、이행구체적、이행구지수、총PSA、유총비(f/tPSA)、조직염증대IPSS치적영향,병진행다원선성회귀분석.결과 년령、이행대체적、Qmax、PSA급전렬선조직염증대IPSS평분영향현저.수착년령증대화이행대체적적증가,IPSS치변대；수착최대뇨류솔적감소,IPSS치현저증가(P＜0.05).당PSA ≥4 ng/mL시,IPSS치요현저대우＜4 ng/mL조(P＜0.05),단시개우4～10 ng/mL조화≥10 ng/mL조적IPSS평분병무차이(P＞0.05).합병전렬선조직염증환자적IPSS치요현저고우비염증조(P＜0.05).진일보통과다원선성회귀분석,발현소유가능영향IPSS평분적인소중,Qmax화전렬선조직염증여IPSS평분밀절상관(β=-0.807,5.736;P＜0.001).결론 전렬선조직염증화Qmax대하뇨로증상적영향최현저.기타적림상인소여환자년령、이행대체적화PSA치대BPH환자적하뇨로증상영향유한,경과다인소회귀분석발현병무현저성.
Objectives To explore the relationship between different clinical factors and lower urinary tract symptoms (LUTS) suggestive of benign prostate hyperplasia (BPH),in order to understand the impact of the risk factors on BPH related LUTS.Methods 548 patients with BPH were enrolled from July 2003 to Octorber 2009 and their clinical data were studied retrospectively.The impact of various clinical factors such as age,medical history,maximum urinary flow rate(Qmax),total prostate volume,transition zone volume,transition zone index,total PSA,f/tPSA and prostatic inflammation on IPSS scores were analyzed,and multiple liner regression analysis was also conducted.Results Among all the clinical factors mentioned above,age,transition zone volume,Qmax,PSA and prostatic inflammation had a significant impact on the IPSS score.IPSS scores increased significantly with the increase of age and transitional zone volume,while IPSS scores increased significantly with the reduction in Qmax (P ＜0.05).IPSS scores were significantly higher in the group of PSA≥4ng/ml than that of PSA ＜4ng/ml (P ＜0.05),however,there was no difference between the group of PSA range of 410ng/ml and that of PSA≥10ng/ml (P ＜0.05).Patients with prostate inflammation had much higher IPSS score than those patients without prostate inflammation (P ＜ 0.05).Further analysis by multiple liner regression found that Qmax and prostate tissue inflammation were closely correlated with the IPSS score among all the possible risk factors (β =-0.807,5.736 ; P ＜ 0.001).Conclusions This study shows that prostate tissue inflammation and Qmax have a remarkable impact on the severity of LUTS,and other clinical factors such as patient's age,transition zone volume and PSA value have a limited impact on the severity of LUTS suggestive of BPH as no significance is found after multiple liner regression analysis.