坦索罗辛治疗前列腺体积小于40ml的前列腺增生合并膀胱过度活动症患者有效性的相关因素分析  

Analysis of factors related to the efficacy of Tamsulosin monotherapy for overactive bladder symptoms in benign prostatic hyperplasia patients with the prostate volume<40ml

作　　者：王劲夫[1] 吴鹏杰[1] 刘圣杰[1] 张耀光[1] 刘明[1] 王建业[1] Wang Jinfu;Wu Pengjie;Liu Shengjie;Zhang Yaoguang;Liu Ming;Wang Jianye(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科、国家老年医学研究中心、中国医学科学院老年医学研究院,100730

出　　处：《中华老年医学杂志》2023年第1期62-66,共5页Chinese Journal of Geriatrics

摘　　要：目的观察坦索罗辛单药治疗前列腺体积(PV)<40 ml的前列腺增生(BPH)合并膀胱过度活动症(OAB)患者的有效性,并分析影响疗效的相关因素。方法入组PV<40 ml的BPH合并OAB患者300例,平均(66.9±7.7)岁,调查吸烟、饮酒等生活习惯,口服坦索罗辛0.2 mg,每晚1次,治疗4周,采集治疗前后OAB症状评分(OABSS)评分、国际前列腺症状评分(IPSS)及生活质量(QOL)评分,最大尿流率(Qmax)、膀胱残余尿量(PVR)。以OBASS作为主要观察指标,分析年龄、生活习惯、治疗前症状评分、PV、Qmax、PVR等因素与治疗效果的相关性。结果完成研究257例,治疗有效169例,总体治疗有效率65.8%,轻、中、重度OAB组治疗有效率分别为83.6%、62.4%、38.5%,三组有效率比较差异有统计学意义(χ2=13.037,P=0.001);3例患者出现药物不良反应,其中2例以轻度头晕为主,1例出现恶心的症状。OAB治疗有效组基线OABSS评分、吸烟患者比例、饮酒患者比例均明显低于无效组,多因素分析结果显示基线OABSS评分(OR=0.735,P<0.001)和吸烟(OR=2.111,P=0.029)是影响坦索罗辛治疗PV<40 ml的BPH合并OAB有效性的相关因素。结论坦索罗辛对PV<40 ml的BPH合并轻度OAB患者治疗有效率较高,基线OABSS评分、吸烟是影响坦索罗辛对此类患者OAB症状疗效的相关因素。Objective To assess the efficacy of Tamsulosin monotherapy for overactive bladder(OAB)symptoms in benign prostatic hyperplasia(BPH)patients with the prostate volume(PV)<40 ml,and to analyze related factors affecting the efficacy.Methods 300 BPH patients with OAB were enrolled,with an average age of(66.9±7.7)years and the PV<40 ml.Smoking,drinking and other living habits were investigated.Data on the Overactive Bladder Symptom Score(OABSS),International Prostate Symptom Score(IPSS)and Quality of Life Scale(QOLS)were collected before and after 4 weeks of treatment with Tamsulosin 0.2 mg QN.The maximum urine flow rate(Qmax)and bladder residual urine volume(PVR)were measured before and after treatment.OBASS was used as the main assessment parameter to analyze the correlation of efficacy with age,lifestyle,pre-treatment symptom scores,PV,Qmax and PVR.Results 257 patients completed the study,and 169 patients were treated effectively,with an overall effectiveness rate of 65.8%.The effectiveness rates of the mild,moderate and severe OAB groups were 83.6%,62.4%and 38.5%,respectively,with statistical significance(χ2=13.037,P=0.001).3 patients showed adverse drug reactions,including 2 patients with mild dizziness and 1 patient with nausea.The baseline OABSS score,the proportion of smoking patients and the proportion of drinking patients in the effectively treated OAB group were significantly lower than those in the ineffectively treated group.Multivariate analysis showed that baseline OABSS score(OR=0.735,P<0.001)and smoking(OR=2.111,P=0.029)were correlated with tamsulosin's efficacy in treating BPH patients with OAB with PV<40 ml.Conclusions The effectiveness rate of Tamsulosin for the treatment of BPH patients with mild OAB with PV<40 ml is high.The baseline OABSS score and smoking are factors affecting the efficacy of Tamsulosin on OAB symptoms in these patients.

关 键 词：前列腺增生 膀胱 过度活动性 肾上腺素能Α拮抗剂 因素分析 

分 类 号：R697.3[医药卫生—泌尿科学] R694[医药卫生—外科学]