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
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摘要
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 t PSA and f PSA 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 Insulin-like growth factor 1( IGF-1) and t PSA,f PSA 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 < 0. 05). Before treatment,there were no significant difference in IPSS score between the three groups( P > 0. 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 < 0. 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 improved( 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 t PSA,f PSA and t PSA/f PSA among the three groups( P > 0. 05); After treatment,the t PSA,f PSA and t PSA/f PSA were significantly improved among three groups( P < 0. 05),and the combined group t PSA,f PSA level were lower than the other two groups( P < 0. 05),t PSA/f PSA 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 t PSA and f PSA. At the same time,the t PSA and f PSA have certain guiding significance for the diagnosis and treatment of benign prostatic hyperplasia.
Objective To explore the influence of finasteride and tamsulosin on t PSA and f PSA 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 Insulin-like growth factor 1( IGF-1) and t PSA,f PSA 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 < 0. 05). Before treatment,there were no significant difference in IPSS score between the three groups( P > 0. 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 < 0. 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 improved( 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 t PSA,f PSA and t PSA/f PSA among the three groups( P > 0. 05); After treatment,the t PSA,f PSA and t PSA/f PSA were significantly improved among three groups( P < 0. 05),and the combined group t PSA,f PSA level were lower than the other two groups( P < 0. 05),t PSA/f PSA 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 t PSA and f PSA. At the same time,the t PSA and f PSA have certain guiding significance for the diagnosis and treatment of benign prostatic hyperplasia.
引文
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[6]王中华,刘素群,杜莉红.大剂量坦索罗辛联合富马酸非索罗定治疗良性前列腺增生伴膀胱活动过度的疗效[J].中国现代医学杂志,2015,25(34):27-30.
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[10]Jin S,Fan D,Liu Z,et al.102 Methylation of Cp G islands in promoter of type 2 5-αreductase and implications of finasteride resistance for BPH therapy[J].European Urology Supplements,2016,15(3):102.
[11]Fawzi A,Kamel M,Salem E,et al.Sildenafil citrate in combination with tamsulosin versus tamsulosin monotherapy for management of male lower urinary tract symptoms due to benign prostatic hyperplasia:A randomised,double-blind,placebo-controlled trial[J].Arab Journal of Urology,2016,15(1):53.
[12]刘俊峰,李三祥,谭朝晖,等.度他雄胺联合坦索罗辛治疗良性前列腺增生疗效分析[J].中国现代医学杂志,2014,24(20):65-67.
[13]Nickel I JC,Roehrborn CG,Castro Santamaria R,et al.Chronic prostate inflammation is associated with severity and progression of benign prostatic hyperplasia,lower urinary tract symptoms and risk of acute urinary retention[J].Journal of Urology,2016,196(5):1493-1498.
[14]张华,钟白云,王新华,等.血清t-PSA及f-PSA/t-PSA联合诊断前列腺癌的价值评价[J].中国现代医学杂志,2014,24(7):24-27.
[15]Pirozzi L,Sountoulides P,Castellan PA,et al.Current pharmacological treatment for male LUTS due to BPH:dutasteride or finasteride[J].Current Drug Targets,2015,16(11):1165-1171.
[2]刘芳,杨小荣,刘焕兵,等.老年良性前列腺增生合并糖尿病患者的尿流动力学检测[J].中国老年学杂志,2016,36(2):342-343.
[3]杨小淮,李庆文,刘贝贝,等.前列腺手术患者是否合并急性尿潴留术后早期并发症的差异分析[J].中国老年学杂志,2015,35(16):4608-4610.
[4]Llop E,Ferrer Batalle M,Barrabes SA,et al.Improvement of prostate cancer diagnosis by detecting PSA Glycosylation-Specific changes[J].Theranostics,2016,6(8):1190-1204.
[5]范海根.非那雄胺联合二甲双胍治疗老年良性前列腺增生合并糖尿病的疗效[J].中国老年学杂志,2015,35(9):2531-2532.
[6]王中华,刘素群,杜莉红.大剂量坦索罗辛联合富马酸非索罗定治疗良性前列腺增生伴膀胱活动过度的疗效[J].中国现代医学杂志,2015,25(34):27-30.
[7]Denis L,Griffiths K,Khoury S,et al.Proceeding of the 2nd International Consultation on BPH[R].Plymouth,United Kingdom,Health Publication,1998.
[8]张祥华.良性前列腺增生临床诊疗指南[J].中华外科杂志,2007,45(24):1704-1707.
[9]李朝明,周鹏,徐啊白,等.经尿道前列腺解剖性剜除术治疗良性前列腺增生前后前列腺特异性抗原的变化[J].广东医学,2015,36(21):3348-3350.
[10]Jin S,Fan D,Liu Z,et al.102 Methylation of Cp G islands in promoter of type 2 5-αreductase and implications of finasteride resistance for BPH therapy[J].European Urology Supplements,2016,15(3):102.
[11]Fawzi A,Kamel M,Salem E,et al.Sildenafil citrate in combination with tamsulosin versus tamsulosin monotherapy for management of male lower urinary tract symptoms due to benign prostatic hyperplasia:A randomised,double-blind,placebo-controlled trial[J].Arab Journal of Urology,2016,15(1):53.
[12]刘俊峰,李三祥,谭朝晖,等.度他雄胺联合坦索罗辛治疗良性前列腺增生疗效分析[J].中国现代医学杂志,2014,24(20):65-67.
[13]Nickel I JC,Roehrborn CG,Castro Santamaria R,et al.Chronic prostate inflammation is associated with severity and progression of benign prostatic hyperplasia,lower urinary tract symptoms and risk of acute urinary retention[J].Journal of Urology,2016,196(5):1493-1498.
[14]张华,钟白云,王新华,等.血清t-PSA及f-PSA/t-PSA联合诊断前列腺癌的价值评价[J].中国现代医学杂志,2014,24(7):24-27.
[15]Pirozzi L,Sountoulides P,Castellan PA,et al.Current pharmacological treatment for male LUTS due to BPH:dutasteride or finasteride[J].Current Drug Targets,2015,16(11):1165-1171.