基于多中心大型队列研究构建老年前列腺增生综合防控体系

The Construction of Comprehensive Prevention and Control System ofBenign Prostatic Hyperplasia in the Elderly Based ona Multi-Center Large Cohort Study

前列腺增生是一种常见的增龄性中老年男性疾病,病因和发病机制复杂,临床症状表现多种,药物治疗缺乏特异性且复发率较高,因此前列腺增生的诊断/鉴别诊断、治疗和预后判断标准一直是临床关注的焦点。然而目前临床前列腺增生治疗路径的起点取决于患者症状和困扰程度,缺乏大型前列腺增生人群队列研究以及高危易患人群筛选方法,缺乏特异性诊断和预警指标,更无老年前列腺增生个体化精准防控措施。针对这些问题,国家重点研发项目“主动健康和老龄化科技应对”专项“老年前列腺增生的综合防控技术研究与精准风险评估和个体化防治措施应用示范”项目,通过建立多中心大型队列研究及广覆盖的专业防控联盟,探索前列腺增生发生进展相关因素,形成精准预警与个体化防控体系;进行老年前列腺增生早期诊断生物标志物筛选和检测试剂盒研发;系统研究影像学前列腺增生增龄性、病理性变化规律及对手术的指导意义,制定老年前列腺增生影像学诊断方案;优化微创手术术式及术后伴发疾病的治疗和综合防控措施;开展前列腺增生继发性膀胱功能损伤的机制及防治研究;结合人工智能建立线下实时预警模型和个性化精准评估模型并应用。从而在前列腺增生早期防、诊、治、控各环节存在的瓶颈问题入手重点攻关,为老年前列腺增生综合防控提供有力保障。

Benign prostatic hyperplasia(BPH)is a common disease in middle-aged and elderly men with features of complex etiology and pathogenesis,multiple clinical symptoms,lack of specificity of drug treatment and high recurrence rate.Therefore,the diagnosis/differential diagnosis,treatment and prognosis criteria of BPH have drawn lots of clinical attentions.However,the starting point of the current clinical treatment path for BPH depends on patients’symptoms and the degree of distress.There is a lack of large-scale cohort study of benign prostatic hyperplasia and screening methods,specific diagnosis and early warning indicators for high-risk and vulnerable populations.There is no individualized and precise prevention and control measures for elderly BPH.In view of these problems,the National Key R&D Program of China“Active health and aging technology response”special“Comprehensive prevention and control technology research and precise risk assessment and application demonstration of individualized prevention and control measures for elderly prostatic hyperplasia”project explored potential factors related to the progress of prostatic hyperplasia through the establishment of a multi-center large-scale cohort study and a wide coverage professional prevention and control alliance,and formed a precise early warning and individualized prevention and control system.Our team carried out the screening of biomarkers for the early diagnosis of BPH in the elderly and the development of detection kits,systematically studied the aging and pathological changes of BPH in imaging and its guiding significance for surgery,and formulated the imaging diagnosis scheme for BPH in the elderly;We optimized the minimally invasive surgery and the treatment and comprehensive prevention and control measures of postoperative concomitant diseases;We also established an early warning model and a personalized accurate evaluation model combining with artificial intelligence.Finally,we focused on tackling the bottleneck problems in the early prevention,diagnosis,treatment and control of BPH,and provided a strong guarantee for the comprehensive prevention and control of BPH in the elderly.