中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
4期
380-384
,共5页
曾小芳%屈晓冰%董莉妮%赵晓昆%张湘瑜
曾小芳%屈曉冰%董莉妮%趙曉昆%張湘瑜
증소방%굴효빙%동리니%조효곤%장상유
前列腺增生%代谢综合征X%羟甲基戊二酰基COA还原酶抑制剂
前列腺增生%代謝綜閤徵X%羥甲基戊二酰基COA還原酶抑製劑
전렬선증생%대사종합정X%간갑기무이선기COA환원매억제제
Prostatic hyperplasia%Metabolic syndrome X%Hydroxymethylglutary-CoA reductase inhibitors
目的 探讨辛伐他汀和阿托伐他汀对老年良性前列腺增生(BPH)合并代谢综合征(MS)患者BPH临床进展的治疗作用. 方法 应用随机对照方法,将年龄≥60岁BPH合并MS患者135例随机分为对照组(45例)、辛伐他汀组(45例,40 mg/d)和阿托伐他汀组(45例,20 mg/d).干预前和干预12个月后分别检测体质指数(BMI)、腰围、血压、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、睾酮、雌二醇、前列腺特异性抗原(PSA)水平、国际前列腺症状评分(IPSS)及前列腺体积. 结果 (1)与对照组比较,12个月后辛伐他汀组和阿托伐他汀组TG、TC、LDL-C水平明显下降(P＜0.05),HDL-C水平明显升高(P＜0.05),hs CRP、IL-6水平明显下降(P＜0.05),IPSS评分及前列腺体积也明显下降(P＜0.05).前列腺体积缩小程度辛伐他汀组为(10.86±5.65)ml,阿托伐他汀组为(5.91±3.03)ml,差异有统计学意义(P=0.049).(2)多元逐步回归分析发现,他汀类干预前后TC、IL-6水平的下降及HDL C水平的升高与前列腺体积缩小明显相关(t=2.437,2.463,-2.952,均P＜0.05),即TC、IL-6水平的下降程度越大及HDL-C水平的升高程度越大,则前列腺体积缩小越明显. 结论 辛伐他汀和阿托伐他汀治疗对BPH合并MS老年人有缩小前列腺体积、改善下尿路梗阻症状的作用,其中辛伐他汀缩小前列腺体积的作用较阿托伐他汀明显.他汀药物可能通过调脂、抗炎等机制起到延缓前列腺增生临床进展的作用.
目的 探討辛伐他汀和阿託伐他汀對老年良性前列腺增生(BPH)閤併代謝綜閤徵(MS)患者BPH臨床進展的治療作用. 方法 應用隨機對照方法,將年齡≥60歲BPH閤併MS患者135例隨機分為對照組(45例)、辛伐他汀組(45例,40 mg/d)和阿託伐他汀組(45例,20 mg/d).榦預前和榦預12箇月後分彆檢測體質指數(BMI)、腰圍、血壓、空腹血糖(FBS)、糖化血紅蛋白(HbA1c)、三酰甘油(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、高敏C反應蛋白(hs-CRP)、白介素-6(IL-6)、睪酮、雌二醇、前列腺特異性抗原(PSA)水平、國際前列腺癥狀評分(IPSS)及前列腺體積. 結果 (1)與對照組比較,12箇月後辛伐他汀組和阿託伐他汀組TG、TC、LDL-C水平明顯下降(P＜0.05),HDL-C水平明顯升高(P＜0.05),hs CRP、IL-6水平明顯下降(P＜0.05),IPSS評分及前列腺體積也明顯下降(P＜0.05).前列腺體積縮小程度辛伐他汀組為(10.86±5.65)ml,阿託伐他汀組為(5.91±3.03)ml,差異有統計學意義(P=0.049).(2)多元逐步迴歸分析髮現,他汀類榦預前後TC、IL-6水平的下降及HDL C水平的升高與前列腺體積縮小明顯相關(t=2.437,2.463,-2.952,均P＜0.05),即TC、IL-6水平的下降程度越大及HDL-C水平的升高程度越大,則前列腺體積縮小越明顯. 結論 辛伐他汀和阿託伐他汀治療對BPH閤併MS老年人有縮小前列腺體積、改善下尿路梗阻癥狀的作用,其中辛伐他汀縮小前列腺體積的作用較阿託伐他汀明顯.他汀藥物可能通過調脂、抗炎等機製起到延緩前列腺增生臨床進展的作用.
목적 탐토신벌타정화아탁벌타정대노년량성전렬선증생(BPH)합병대사종합정(MS)환자BPH림상진전적치료작용. 방법 응용수궤대조방법,장년령≥60세BPH합병MS환자135례수궤분위대조조(45례)、신벌타정조(45례,40 mg/d)화아탁벌타정조(45례,20 mg/d).간예전화간예12개월후분별검측체질지수(BMI)、요위、혈압、공복혈당(FBS)、당화혈홍단백(HbA1c)、삼선감유(TG)、총담고순(TC)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)、고민C반응단백(hs-CRP)、백개소-6(IL-6)、고동、자이순、전렬선특이성항원(PSA)수평、국제전렬선증상평분(IPSS)급전렬선체적. 결과 (1)여대조조비교,12개월후신벌타정조화아탁벌타정조TG、TC、LDL-C수평명현하강(P＜0.05),HDL-C수평명현승고(P＜0.05),hs CRP、IL-6수평명현하강(P＜0.05),IPSS평분급전렬선체적야명현하강(P＜0.05).전렬선체적축소정도신벌타정조위(10.86±5.65)ml,아탁벌타정조위(5.91±3.03)ml,차이유통계학의의(P=0.049).(2)다원축보회귀분석발현,타정류간예전후TC、IL-6수평적하강급HDL C수평적승고여전렬선체적축소명현상관(t=2.437,2.463,-2.952,균P＜0.05),즉TC、IL-6수평적하강정도월대급HDL-C수평적승고정도월대,칙전렬선체적축소월명현. 결론 신벌타정화아탁벌타정치료대BPH합병MS노년인유축소전렬선체적、개선하뇨로경조증상적작용,기중신벌타정축소전렬선체적적작용교아탁벌타정명현.타정약물가능통과조지、항염등궤제기도연완전렬선증생림상진전적작용.
Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia (BPH) in elderly patients with metabolic syndrome (MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group (n=45,40 mg/d),atorvastatin group (n=45,20 mg/d) and control group (n=45).BMI,waist circumference,blood pressure,levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL C),high sensitivity C-reactive protein (hs-CRP),interleukin 6 (IL-6),testosterone,estradiol,prostate specific antigen (PSA) and international prognostic scoring system (IPSS) and prostate volume were detected before and 12 months after treatment.Results Compared with control group,patients receiving simvastatin or atorvastatin for 12 months showed that the levels of serum TC,TG,LDL-C,hs-CRP,IL-6,IPSS were decreased(all P＜0.05),the level of serum HDL-C level were increased (all P＜0.05),and prostate volume was reduced(P＜0.05).The decrease in prostate volume was more in patients receiving simvastatin than receiving atorvastatin [(10.86±5.65) ml vs.(5.91 ± 3.03)ml,P＜0.05].Multiple stepwise regression analysis showed that the reduction of prostate volume was positively related to the decreases of serum TC and IL-6 levels,and to the increase of serum HDL-C level.Conclusions Simvastatin and atorvastatin have the efficacy reducing prostate volume and improving obstruction symptoms of lower urinary tract,and slowing the clinical progression of BPH and simvastatin is more effective than atorvastatin on reducing prostate volume.The efficacies of statins might be through lowering cholesterol level and antiinflammatory effect.
