非那雄胺治疗老年良性前列腺增生合并原发性高血压患者的效果及对炎性因子和黏附分子的影响

Efficacy of finasteride on elderly patients of benign prostatic hyperplasia with primary hypertension and its influence on inflammatory cytokines and adhesion molecules

目的探讨非那雄胺治疗老年良性前列腺增生（BPH）合并原发性高血压患者的效果及对炎性因子和黏附分子的影响。方法将110例老年男性BPH合并原发性高血压患者随机分为对照组55例（予标准化治疗）和非那雄胺组55例（予标准化治疗联合非那雄胺5mg／d），于基线及治疗48周后分别检测两组患者血清白细胞介素（IL）-6、超敏C反应蛋白（hs—CRP）、血管性血友病因子（vWF）、血管内皮细胞黏附分子（VCAM）-1、总前列腺特异抗原（tPSA）、游离前列腺特异抗原（fPSA）、睾酮水平，比较治疗前后血压、国际前列腺症状评分（IPSS）及前列腺体积的变化。结果与治疗前比较，治疗后两组患者甘油三酯、IL-6、vWF、VCAM-1水平均降低，且非那雄胺组水平低于对照组（P〈0．05）。与治疗前比较，治疗后两组患者hs—CRP水平均降低（P〈0．05），但两组间比较差异无统计学意义（P〉0．05）。非那雄胺组治疗后tPSA和fPSA水平均较治疗前降低，且其水平低于对照组（P〈0．05）。与治疗前比较，治疗后两组患者IPSS均降低（P〈0．05），且非那雄胺组IPSS低于对照组（P〈0．05）；治疗后非那雄胺组前列腺体积缩小（P〈0．05），而对照组治疗前后前列腺体积比较差异无统计学意义（P〉0．05）。结论非那雄胺可能通过降低炎症水平、纠正黏附分子异常状态、调节血管内皮功能影响老年BPH合并原发性高血压患者的血压水平。

Objective To explore the clinic efficacy of finasteride on elderly patients of benign prostatic hyperplasia（BPH） with primary hypertension and influence on inflammatory cytokines and adhesion molecules. Methods A total of 110 elderly male patients of BPH with primary hypertension were randomly divided into control group （ 55 cases, with standardized treatment） and finasteride group （55 cases, with normalized treatment and finasteride 5 mg/d）. Levels of serum interleukin （IL）-6, high-sensitivity C-reactive protein（ hs-CRP）, yon willebrand factor （vWF）, vascular endothelial cell adhesion molecule （VCAM） - 1, total prostate specific antigen （tPSA）, free prostate specific antigen （ tPSA ） and testosterone were detected respectively in two groups at baseline and 48 weeks after treatment. Changes of blood pressure, international prostate symptom score（IPSS） and prostate volume were compared before and after treatment. Results Compared with before treatment,levies of triglyceride,IL-6,vWF and VCAM-1 in two groups after treatment all decreased and those in finasteride group were all lower than those in the control group （ P 〈 0.05 ）. Compared with before treatment,level of hs-CRP in two groups after treatment both decreased （P 〈 0.05 ）, but there was no significant difference between two groups after treatment （P 〉 0. 05 ）. Levels of tPSA and tPSA after treatment were lower than those before treatment in finasteride group and those in control group（P 〈 0.05）. Compared with before treatment, 1PSS in two groups decreased and IPSS in finasteride group was lower than that in control group （P 〈 0.05 ）. Compared with before treatment, prostate volume in finasteride group after treatment decreased （ P 〈 0.05 ）, but prostate volume before and after treatment in control group was not significantly different（P 〉0.05）. Conclusion Finasteride may affect blood pressure in elderly patients with BPH and primary hypertension by reducing the level of inflammation, correcting abnormalities of adhesion molecules and regulating function of vascular endothelial.