他汀类药物的使用与良性前列腺增生和下尿路症状相关性的临床研究

Oral medication of statins retards the progression of benign prostatic hyperplasia and lower urinary tract symptoms

目的：探讨服用他汀类药物是否可延缓良性前列腺增生（BPH）和下尿路症状的临床进展。方法：选择2003年1月至2008年12月于我院体检中心体检的50～69岁男性作为研究对象，制定纳入标准，随访5年，通过比较IPSS评分、最大尿流率（Qmax）和前列腺体积（PV）探讨他汀类药物的使用与前列腺增生和下尿路症状临床进展的相关性。结果：总共有653例男性纳入本研究，其中他汀类药物使用组（1组）283例，他汀类药物未使用组（2组）370例，两组入选时的年龄、IPSS评分、Qmax和PV差异均无显著性（P〉0．05），随访过程中因出现明显的排尿困难各剔除24例（1组）和35例（2组）。5年随访过程中1组和2组的IPSS评分都逐渐升高，但1组升高程度明显低于2组（P〈0．01），1组和2组的Qmax都逐渐下降，但1组下降程度明显低于2组（P〈0．01）；1组[PV5年分别为（22．60±4．99）、（25．80±5．20）、（27．92±5．05）、（29．11±5．24）、（29．97±5．26）ml]和2组[5年分别为（24．30±4．98）、（28．50±5．14）、（32．84±4．77）、（36．99±4．78）、（40．90±4．78）m1]的PV都逐渐增大，但1组增大程度明显小于2组（P〈0．01）。结论：使用他汀类药物可明显延缓BPH和下尿路症状的临床进展，且长时间服用疗效更显著。

Objective： To determine whether oral statins can delay the progression of benign prostatic hyperplasia （BPH） and lower urinary tract symptoms （LUTS）. Methods： We conducted a retrospective cohort study of 50 -69-year-old males who came for physical examination in our hospital between January 2003 and December 2008. We designed the inclusion criteria, followed them up for 5 years, and investigated the relationship of oral statins with the clinical progression of BPH and LUTS. Results： Totally, 653 men met the inclusion criteria and were included in this study, of whom 283 were treated with oral statins （ group 1 ） while the other 370 with none （group 2）. There were no statistically significant differences between the two groups in age and baseline IPSS, Qmax, and prostate volume （PV） （P 〉0.05）. During the follow-up, 24 cases in group 1 and 35 cases in group 2 were excluded for obvious dys-uria. A gradual increase was observed in IPSS in both groups 1 and 2 year by year from the baseline to the 5th year of follow-up,but significantly lower in the former group （4.27 ± 1.16, 4.63 ± 1.05, 5.27 ±O. 96, 6.41±1.04, 7.21 ±1. 21, and 7.93 ± 1.50） than in the latter （4.24 ± 1.35, 5.26 ± 1.23,6.84 ± 1.20, 8.75±1.84, 10.82 ±3.01, and 12.98 ±4.21） （P〈O. O1） ; a gradual decrease was seen in Qmax, though markedly higher in group 1 （ [ 26.56 ± 2.09 ], [ 24.06 ± 1.94 ], [ 21.33 ± 1.66 ], [ 19.24± 1.54], [17.44±1.53], and [16.27 ±1.37] ml/s） than in group2 （[26.74±2.40], [23.62 ±2.01], [20.63±1.69], [17.72 ±1.48], [14.82 ±1.11], and [11.86±1.24] ml/s） （P 〈0.01） ; and a gradual increase was found in PV, but remark- ably smaller in the former group （ [ 19.82± 4.94 ], [ 22.60 ± 4.99 ], [ 25.80 ± 5.20 ], [ 27.92 ± 5.05 ], [ 29.11 ± 5.24 ], and [29.97 ±5.26] ml） than in the latter （[20.21±4.78], [24.30 ±4.98], [28.50±5.14], [32.84 ±4.77], [36.99 ±4.78], and [ 40.90 ± 4.78 ] ml） （P 〈 0.01 ）. Longer medication of statins was associated with better efficacy. Conclusion： Oral statins can significantly delay the clinical progression of BPH and LUTS.