CAJ | 학술논문

目的探讨非那雄胺和多沙唑嗪联合治疗前列腺增生(BPH)合并下尿路症候群(LUTS),对不同程度中央区腺体增生(前列腺膀胱内突出部分)(IPP)的效果. 方法本次研究入组322例患者,存在前列腺体积增大以及显著的LUTS症状,所有患者采用非那雄胺5 mg和多沙唑嗪4 mg每天1次联合治疗,6个月为观察终点.根据超声检查提示的IPP的程度,患者分成4组:＞10 mm 33例,5～10 mm 46例,＜5 mm 65例；没有IPP的BPH患者178例作为对照组.组内分析比较药物治疗前后国际前列腺症状评分(IPSS),前列腺特异抗原(PSA)以及超声检查数据的变化,COX回归分析上述因素与IPP的相关关系. 结果本次研究的患者在药物联合治疗6个月后,三组的IPP程度和最大尿流率在治疗后没有明显变化(P＞0.05),同时,第一组患者的IPSS分数也没有明显改善(P＞0.05)；而其余患者的PSA,IPSS,前列腺体积(TPV),前列腺移行区体积(TZV)和残余尿量(PVR)则在治疗前后比较明显减少(P＜0.05).COX回归分析结果提示,残余尿量和最大尿流率与IPP分别呈正相关和负相关(P＜0.001和P=0.024). 结论 BPH/LUTS患者6个月的联合治疗可以明显改善症状,缩小体积,但是对于BPH合并IPP的患者,联合治疗并不能有效缓解IPP的程度.
목적 탐토비나웅알화다사서진연합치료전렬선증생(BPH)합병하뇨로증후군(LUTS),대불동정도중앙구선체증생(전렬선방광내돌출부분)(IPP)적효과. 방법 본차연구입조322례환자,존재전렬선체적증대이급현저적LUTS증상,소유환자채용비나웅알5 mg화다사서진4 mg매천1차연합치료,6개월위관찰종점.근거초성검사제시적IPP적정도,환자분성4조:＞10 mm 33례,5～10 mm 46례,＜5 mm 65례；몰유IPP적BPH환자178례작위대조조.조내분석비교약물치료전후국제전렬선증상평분(IPSS),전렬선특이항원(PSA)이급초성검사수거적변화,COX회귀분석상술인소여IPP적상관관계. 결과 본차연구적환자재약물연합치료6개월후,삼조적IPP정도화최대뇨류솔재치료후몰유명현변화(P＞0.05),동시,제일조환자적IPSS분수야몰유명현개선(P＞0.05)；이기여환자적PSA,IPSS,전렬선체적(TPV),전렬선이행구체적(TZV)화잔여뇨량(PVR)칙재치료전후비교명현감소(P＜0.05).COX회귀분석결과제시,잔여뇨량화최대뇨류솔여IPP분별정정상관화부상관(P＜0.001화P=0.024). 결론 BPH/LUTS환자6개월적연합치료가이명현개선증상,축소체적,단시대우BPH합병IPP적환자,연합치료병불능유효완해IPP적정도.
Objective To evaluate the efficacy of combination therapy with finasteride and doxazosin in benign prostatic hyperplasia/ lower urinary tract symptoms (BPH/LUTS) patients with intravesical prostatic profusion (IPP).Methods A total of 322 BPH/LUTS patients who accepted combination therapy with finasteride and doxazosin were enrolled in this study.Patients were divided into 4 groups according to the degree of IPP:group Ⅰ(IPP＞10 mm),group 2 (IPP between 5 mm and 10 mm),group 3 (IPP＜5 mm),control group (without IPP).All patients were received inasteride 5 mg once per day and doxazosin 4 mg once per day for 6 months.International prostate symptom score (IPSS),prostatic specific antigen(PSA),ultrasonographic and urcdynamic evaluation were compared before and after treatment.The correlations between the above factors and IPP were estimated by Logistic regression analysis.Results After 6 month of treament,the changes of IPP degree and the maximal urinary flow rate (Qmax) had no significant differences in group 1,group 2 and group 3 as compared with before treatment (all P＞0.05).The IPSS in group 1 was not significantly different before and after treatment (P＞0.05).There were significant differences in the PSA level,IPSS,total prostate volume (TPV),transition zone volume (TZV),residual urine volume (PVR) in the 4 groups before and after treatment (all P＜0.05).Logistic regression analysis showed that PVR and Qmax had positive and negative correlations with IPP (P＜0.001 and P=0.024),respectively.Conclusions Combination therapy with finasteride and doxazosin can significantly improve the symptoms of LUST and reduce the total prostate volume in patients with BPH/LUTS,but for BPH patients with IPP,the combination therapy can not effectively alleviate the degree of IPP.The increase of residual urine volume and decrease of Qmax may enhance the risk of bladder outlet obstruction in BPH patients with IPP.