非那雄胺联合坦索罗辛治疗对老年良性前列腺增生患者tPSA、fPSA的影响

The influence of finasteride and tamsulosin on tPSA and fPSA in elderly patients with benign prostatic hyperplasia

目的探究非那雄胺联合坦索罗辛治疗对老年良性前列腺增生患者t PSA、f PSA的影响。方法将收治的300例老年良性前列腺增生患者随机分成非那雄胺治疗组、坦索罗辛治疗组和联合治疗组,每组100例,对3组患者治疗效果、治疗前后国际前列腺症状评分(IPSS)、前列腺体积、最大尿流率(MFR)、残余尿量、血清胰岛素样生长因子-1(IGF-1)及总前列腺特异抗原(t PSA)、游离前列腺特异抗原(f PSA)进行比较。结果联合治疗组的总显效率为88.0%,显著高于非那雄胺治疗组的63.0%和坦索罗辛治疗组的60%(P<0.05);治疗前3组IPSS评分比较差异无统计学意义(P>0.05),治疗后3组IPSS评分均显著降低(P<0.05),且联合治疗组显著优于其他2组(P<0.05);治疗前3组前列腺体积、MFR、残余尿量和IGF-1水平比较差异无统计学意义(P>0.05),治疗后3组各指标均得到显著改善(P<0.05),且联合治疗组各指标优于其他2组(P<0.05);治疗前3组t PSA、f PSA及t PSA/f PSA比较差异无统计学意义(P>0.05),治疗后3组t PSA、f PSA及t PSA/f PSA均得到显著改善(P<0.05),且联合治疗组t PSA、f PSA水平更低(P<0.05),t PSA/f PSA值更高(P<0.05)。结论非那雄胺联合坦索罗辛治疗老年良性前列腺增生效果显著,可有效改善前列腺增生症状并降低t PSA、f PSA水平,同时t PSA、f PSA对老年良性前列腺增生诊断和治疗具有一定的指导意义。

Objective To explore the influence of finasteride and tamsulosin on tPSA and fPSA in elderly patients with benign prostatic hyperplasia. Methods 300 elderly patients with benign prostatic hyperplasia were selected in our hospital from August 2013 to August 2016, and the patients were randomly divided into finasteride treatment group, tamsulosin treatment group and combined treatment group, 100 cases in each group. Compared the IPSS score ,prostate volume ,maximum flow rate （MFR） residual urine volume, Serum In- sulin - like growth factor 1 （ IGF - 1 ） and tPSA, fPSA before and after treatment among the three groups. Results The total effective rate of combined treatment group was 88% , significantly higher than the finasteride treatment group （63%） and tamsulosin treatment group （ 60% ） （ P 〈 O. 05 ）. Before treatment, there were no significant difference in IPSS score between the three groups （ P 〉 O. 05 ） ; After treatment, the IPSS scores of the three groups were significantly reduced （ P 〈 0.05 ） , and the combined treatment group was significantly better than that in the other two groups （ P 〈 O. 05 ）. Before treatment, there were no significant difference in prostate volume, MFR, residual urine volume and IGF - 1 among the three groups （ P 〉 0.05 ）, after treatment, the three groups each indexes were significantly im- proved （ P 〈 0.05 ）, and the combined treatment group was better than that in the other two groups （ P 〈0. 05 ）. Before treatment, there were no significant difference in tPSA, fPSA and tPSA/fPSA among the three groups （ P 〉 0.05 ） ; After treatment, the tPSA, fPSA and tP- SA/fPSA were significantly improved among three groups （ P 〈0. 05 ） , and the combined group tPSA, fPSA level were lower than the oth- er two groups （ P 〈0. 05 ）, tPSA/fPSA value was higher （ P 〈0. 05 ） than the other two groups. Conclusion There are significant effect of finasteride combined tamsulosin in patients with benign prostatic hyperplasia,it can effectively improve the symptoms of benign prostatic hyperplasia and decrease the level of tPSA and fPSA. At the same time,the tPSA and fPSA have certain guiding significance for the diagnosis and treatment of benign prostatic hyperplasia.