良性前列腺增生临床进展与代谢综合征各成分的回归模型研究

Regression Model Study between the Clinical Progression of Benign Prostatic Hyperplasia and Components of Metabolic Syndrome

目的分析代谢综合征(MS)各成分对老年人良性前列腺增生(BPH)临床病程进展的影响因素。方法将155例BPH患者根据是否患MS分为单纯BPH组(n=86)和BPH合并MS组(n=69),分析2组各代谢指标和BPH指标的差异;分别以BPH患者的前列腺体积(TPV)、残余尿量、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、血清前列腺特异性抗原(PSA)、前列腺年增长率为因变量,以MS各成分为自变量,进行多元线性回归分析。结果单纯BPH组与BPH合并MS组比较,BPH患者的病程进展观察指标PSA、TPV、Qmax、IPSS、前列腺年增长率等的差异均有统计学意义(P<0.05)。多元线性回归显示,与TPV正相关的成分为空腹血糖、胰岛素抵抗指数、腰围(P<0.05);与残余尿量正相关的成分为胰岛素抵抗指数(P<0.05);与Qmax负相关的成分为胰岛素抵抗指数(P<0.01);与IPSS评分正相关的成分为体重指数(P<0.01)、空腹血糖、腰围(P<0.05);与PSA正相关的成分为空腹血糖(P<0.05),与前列腺年增长率正相关的成分为空腹血糖、空腹胰岛素(P<0.05)。结论针对MS中的不同成分,各个BPH临床进展指标各有其独立的影响因素,针对BPH患者不同的临床指标,应采取不同的治疗方案。

Objective To explore the chnical progression factors for the metabohc syndrome （MS） on elderly benign prostatic hyperplasia （BPH）. Methods A total of 155 elderly BPH were divided into two groups：simple BPH （n =86） and BPH with MS （n =69） groups,the differences of the metabolic and BPH index between two groups were compared. By multiple linear regression,the effects and correlation of prostate volume （ TPV ）, residual urine volume, Qmax, international prostate symptom score （ IPSS ）, prostate-specific antigen （ PSA ）, and an- nual prostate growth rate with various components of MS were analyzed. Results There were statistical differences （P 〈 0.05 ） on TPV, Qmax, IPSS, PSA, and annual prostate growth rate between BPH and BPH with MS groups. The multiple linear regression showed that the TPV has a significantly positive correlation with FBG and HOMA-IR. Residual urine volume showed a significantly positive correlation with HOMA-IR. Qmax has a significantly negative correlation with HOMA-IR. IPSS has a significantly positive correlation with BMI, FBG and waist circumference. PSA has a significantly positive correlation with FBG. Annual prostate growth rate has a significantly positive correlation with FBG and FINS. Conclusion MS has evident effects on the development of BPH.