广州地区老年科良性前列腺增生的诊断治疗现状

Diagnostic and therapeutic status of the elderly outpatients with benign prostatic hyperplasia in Guangzhoa

目的 了解广州地区老年科门诊伴有下尿路症状的良性前列腺增生（LUTS/BPH）患者的基本情况及诊治状况. 方法 对广州地区三家三级甲等医院的老年科门诊进行调查,对诊断为LUTS/BPH的患者进行生活的基本状况的问卷调查,同时对门诊医师开具的检查和治疗药物进行分析统计. 结果 6140例男性门诊患者中1824例拟诊LUTS/BPH,占29.7%.在有效回收的调查问卷的134例患者中,国际前列腺症状评分（IPSS）轻、中及重度者分别占24.5%、72.5%及3.0%.血清前列腺特异性抗原（PSA）异常率为37.3%.患者最常接受的检查是直肠指检（96.8%）、PSA（88.7%）和经腹B超（84.8%）.医师开具的药物最常见为单独使用5-α还原酶抑制剂（44.7%）;其次为α-受体拮抗剂及5-α还原酶抑制剂联合使用（24.7%）及其他（植物用药）（16.7%）.单独使用α-受体拮抗剂和单独使用植物制剂的比例相近（分别为6.8%和7.1%）. 结论 LUTS/BPH是老年科男性患者最常见的疾病之一.医师开具的检查不尽合理,对常规的病史询问、IPSS评分等重视不够,医师开具的治疗药物基本合理.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms （LUTS） in the elderly outpatients with benign prostatic hyperplasia （BPH） in Guangzhou.Methods The investigation was conducted in outpatient departments for elderly patients in 3 hospitals of Guangzhou. The eligible male patients with LUTS/BPH were chosen from patients who came to the clinic in the process of investigation. Results The 29.7% （1824/6140） of them had history of LUTS/BPH previously or presently. In 134 patients received medical questionnaire, the proportion of LUTS/BPH patients with mild, middle and severe degree based on international prostate symptom score （IPSS） was 24.5%, 72.5% and 3.0% respectively. The abnormal percentage of PSA was 37. 3 %. The most common examinations that patients received were directeral rectun examination （96.8%）, PSA （88. 7%） and transabdominal ultrasonography （84.8%）. The 44.7% of cases were given the treatment of 5α-reductase inhibitor, and 24.7% of cases received a combination therapy of 5α-reductase inhibitor plus α receptor blocker. The 16.7% of cases were given a combination treatment of 5α-reductase inhibitor plus herbs. The proportion of therapy with α receptor blocker and herbs was similar （6.8% and 7.1% respectively）. Conclusions LUTS/BPH is one of the most common diseases in elderly male patients. The examinations conducted by doctors are unreasonable.The doctors are easy to ignore inquirement of patient＇s history and IPSS. The drugs conducted by doctors are reasonable basically.