观察等待治疗方案下良性前列腺增生症患者24个月随访数据分析  

Study on patients with benign prostate hyperplasia treated by the therapeutic regimen of watchful waiting during a twenty-four-month follow-up period

作　　者：张耀光[1] 王建业[1] 刘明[1] 许进[1] 伍建业[1] 辛英[1] 万奔[1] 魏东[1] 朱生才[1] 曾平[2] 

机构地区：[1]卫生部北京医院泌尿外科,100730 [2]卫生部北京老年医学研究所

出　　处：《中华流行病学杂志》2008年第6期611-613,共3页Chinese Journal of Epidemiology

基　　金：国家科技部“十五”攻关课题资助项目[2001BA702804（A）]

摘　　要：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。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.

关 键 词：良性前列腺增生症 前列腺体积 残余尿 观察等待 随访 

分 类 号：R697.3[医药卫生—泌尿科学]