膀胱内前列腺突出程度对α-受体阻滞剂治疗良性前列腺增生效果的预测

Intravesical prostatic protrusion predict the response to α-blocker in patients with BPH

目的:探讨在良性前列腺增生(BPH)病人中,膀胱内前列腺突出(IPP)程度与α-受体阻滞剂治疗效果的关系。方法:对86例因下尿路症状就诊的BPH病人给予特拉唑嗪2mg,每日一次治疗。行经腹超声通过中线矢状面测量IPP长度,根据IPP程度将病人分为3组。分析每组病人治疗4周后国际前列腺症状评分(IPSS)、最大尿流率和排尿后残余尿量的改善情况。结果:α-受体阻滞剂治疗4周后,在IPP<5mm的42例病人中,IPSS(降低5.5,P<0.05)和最大尿流率(增加3.2ml/s,P<0.05)都有显著改善;在IPP5～10mm的26例病人中,仅有IPSS(降低5.1,P<0.05)显著改善;而在IPP≥10mm的18例病人中,各项疗效指标均无显著改善。结论:本研究结果显示经腹超声测量的IPP程度可以预测α-受体阻滞剂治疗BPH的效果,对于IPP≥10mm的BPH病人,α-受体阻滞剂的治疗效果较差。

Objectives： We investigate the relationship between the response to et -blocker and the degree of intravesical prostatic protrusion （IPP） in patients with BPH. Methods： Consecutive 86 outpatients with BPH presented with lower urinary tract symptoms received 2mg of terazosin, once a day for 4 weeks. The length of IPP was measured in the mid sagittal section by transabdominal ultrasound. The patients were divided into 3 groups based on their IPP degree. The relationship of IPP degree with the improvement of international prostatic symptom score （IPSS）, the maximum uroflow rate （Qmax）, and the postvoid residual urine volume （PVR） were analyzed. Results： After ,4 weeks α-blocker therapy, both IPSS （decreased by 5.5, P 〈0. 05） and Qmax （ increased by 3.2 ml/s, P 〈 0. 05 ） were significantly improved in 42 patients with IPP 〈 5 mm ; only IPSS （ decreased by 5.1, P 〈 0. 05 ） significantly improved in 26 patients with IPP 5 - 10mm ; there were no significantly improved parameters in 18 patients with IPP≥ 10 mm. Conelusions： The results of the present study suggest that the degree of IPP measured by transabdominal ultrasound appears to predict the response to α-blocker in patients with BPH. The treatment of α-blocker is more likely to fail in patients with IPP≥10 mm.