前列腺阻力指数与冠状动脉粥样硬化性心脏病危险因素相关性研究
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摘要
目的探讨良性前列腺增生(benign prostatic hyperplasia,BPH)患者前列腺阻力指数(prostatic resistive index,PRI)与冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAD)的危险因素间的相关性。方法根据是否伴有CAD,将156例BPH患者分为I组和II组,选择同期门诊男性体检者为NC组。统计三组观察对象的空腹血糖(BG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、前列腺特异性抗原(PSA)、前列腺阻力指数(PRI)、前列腺体积(Vp)、体重指数(BMI)、国际前列腺症状评分(IPSS)以及CAD危险因素,包括高血压病(HP)、2型糖尿病(T2DM)、代谢综合征(Met S)、吸烟,对上述各组测量数据和PRI进行相关性及回归分析。结果I、II组的TG、TC、PSA、Vp、PRI、IPSS水平显著高于NC组,II组的TG、TC、PSA、BG、Vp、PRI水平显著高于I组;差异均有统计学意义(均P<0.05)。I、II组的PRI水平与年龄、LDL-C、TG、TC、PSA、BG、Vp、IPSS呈正相关,与HDL-C呈负相关,均有统计学意义(P<0.05)。回归分析显示,两组PRI水平和BG、Vp、Met S、吸烟具有显著相关性(P<0.05)。结论BPH患者PRI水平与CAD危险因素中的代谢综合征和吸烟密切相关,BPH和CAD的发生发展可能存在共同的病理生理机制。
Objective To investigate the correlation between prostate resistance index(PRI)and risk factors of coronary atherosclerotic heart disease(CAD)in benign prostatic hyperplasia(BPH).Methods 156 BPH patients were firstly divided into two groups,namely,group I(patients with CAD)and group II((patients without CAD).Meanwhile,88health volunteers from the outpatient department were chosen as the normal control(NC)group.The fasting blood glucose,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),prostate specific antigen(PSA),prostatic resistance index(PRI),prostate volume(V_P),body mass index(BMI),international prostate symptom score(IPSS),and risk factors of CAD(hypertension,type 2 diabetes,metabolic syndrome,smoking)were analyzed.The correlation and regression analysis between the above data and PRI were made.Results The levels of TG,TC,PSA,V_P,PRI and IPSS in group I and II were higher than those in NC group(P<0.05),The levels of TG、TC、PSA、BG、V_P、PRI in group II were higher than those in group I(P<0.05).The PRI levels in group I and II were positively correlated with age,LDL-C,TG,TC,PSA,BG,V_Pand IPSS,and negatively correlated with HDL-C(P<0.05).Regression analysis showed that the PRI levels of the two groups were significantly correlated with BG,V_P,metabolic syndrome and smoking(P<0.05).Conclusions The level of PRI in BPH patients is closely related to the metabolic syndrome and smoking in CAD risk factors.There may be a common pathophysiological mechanism in the occurrence and development of BPH and CAD.
Objective To investigate the correlation between prostate resistance index(PRI)and risk factors of coronary atherosclerotic heart disease(CAD)in benign prostatic hyperplasia(BPH).Methods 156 BPH patients were firstly divided into two groups,namely,group I(patients with CAD)and group II((patients without CAD).Meanwhile,88health volunteers from the outpatient department were chosen as the normal control(NC)group.The fasting blood glucose,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),prostate specific antigen(PSA),prostatic resistance index(PRI),prostate volume(V_P),body mass index(BMI),international prostate symptom score(IPSS),and risk factors of CAD(hypertension,type 2 diabetes,metabolic syndrome,smoking)were analyzed.The correlation and regression analysis between the above data and PRI were made.Results The levels of TG,TC,PSA,V_P,PRI and IPSS in group I and II were higher than those in NC group(P<0.05),The levels of TG、TC、PSA、BG、V_P、PRI in group II were higher than those in group I(P<0.05).The PRI levels in group I and II were positively correlated with age,LDL-C,TG,TC,PSA,BG,V_Pand IPSS,and negatively correlated with HDL-C(P<0.05).Regression analysis showed that the PRI levels of the two groups were significantly correlated with BG,V_P,metabolic syndrome and smoking(P<0.05).Conclusions The level of PRI in BPH patients is closely related to the metabolic syndrome and smoking in CAD risk factors.There may be a common pathophysiological mechanism in the occurrence and development of BPH and CAD.
引文
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[12]Shinbo H,,Kurita Y,Nakanishi T,et al.Resistive index:a newly identified predictor of outcome of transurethral prostatectomy in patients with benign prostatic hyperplasia[J].Urology,2010,75(1):143-147.
[13]林富祥,高分飞,石刚刚.缺血缺氧与前列腺增生[J].汕头大学医学院学报,2013,30(4):239-241.
[14]Thurmond P,Yang JH,Li Y,et al.Structural modifications of the prostate in hypoxia,oxidative stress,and chronic ischemia[J].Korean journal of urology,2015,56(3):187-196.
[15]Chen Z,Miao L,Gao X,et al.Effect of obesity and hyperglycemia on benign prostatic hyperplasia in elderly patients with newly diagnosed type 2 diabetes[J].International journal of clinical and experimental medicine,2015,8(7):11289-11294.
[2]唐智国,梁朝朝,张艳斌,等.良性前列腺增生症患者的生活质量及其相关影响因素分析[J].中华临床医师杂志:电子版,2015,9(13):2623-2626.
[3]Scattoni V,Maccagnano C.Benign Prostatic Hypertrophy//Atlas of Ultrasonography in Urology,Andrology,and Nephrology[M].Springer,Cham,2017:281-291.
[4]陈伟伟,高润霖,刘力生,等.中国心血管病报告2014[J].中国循环杂志,2015,30(7):617-622.
[5]鲍敏敏.综合评估模式对老年冠心病患者生存质量及治疗依从性的影响[J].健康研究,2015,35(5):564-565.
[6]Baykam MM,Aktas BK,Bulut S,et al.Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia[J].The Kaohsiung journal of medical sciences,2015,31(4):194-198.
[7]中华医学会糖尿病学分会代谢综合征研究协作组.中华医学会糖尿病学分会关于代谢综合征的建议[J].中华糖尿病杂志,2004,12(3):156–161.
[8]崔瑶,刘谦,秦明照.老年共病现状及管理策略[J].中国全科医学,2017,20(23):2816-2819.
[9]Lee S,Chakrabarty B,Papargiris M,et al.Myogenic tone is significantly increased in benign prostatic hyperplasia and can be attenuated by sildenafil and tamsulosin,with outcome associated to patient age and prostate volume[J].European Urology Supplements,2017,16(3):e176.
[10]Vital P,Castro P,Ittmann M.Oxidative stress promotes benign prostatic hyperplasia[J].The Prostate,2016,76(1):58-67.
[11]Zhang XF,Li G,Wei XD,et al.Resistive index of prostate capsular arteries:a newly identified parameter to diagnose and assess badder outlet obstruction in patients with benign prostatic hyperplasia[J].The Journal of urology,2012,188(3):881-887.
[12]Shinbo H,,Kurita Y,Nakanishi T,et al.Resistive index:a newly identified predictor of outcome of transurethral prostatectomy in patients with benign prostatic hyperplasia[J].Urology,2010,75(1):143-147.
[13]林富祥,高分飞,石刚刚.缺血缺氧与前列腺增生[J].汕头大学医学院学报,2013,30(4):239-241.
[14]Thurmond P,Yang JH,Li Y,et al.Structural modifications of the prostate in hypoxia,oxidative stress,and chronic ischemia[J].Korean journal of urology,2015,56(3):187-196.
[15]Chen Z,Miao L,Gao X,et al.Effect of obesity and hyperglycemia on benign prostatic hyperplasia in elderly patients with newly diagnosed type 2 diabetes[J].International journal of clinical and experimental medicine,2015,8(7):11289-11294.