學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 廖俊厚 | 中老年男性造成攝護腺肥大合併下泌尿道症狀的危險因子 | 2010/10/28 下午 02:07:59 | 0 |
| 原 文 | 題 目 | Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community based population of healthy aging men: the Krimpen Study. |
| 作 者 | Kok ET, Schouten BW, Bohnen AM, Groeneveld FP, Thomas S, Bosch JL. Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands. | |
| 出 處 | Journal of Urology. 2009 Feb;181(2):710-6 | |
| 出版日期 | 2009年2月 | |
| 評 論 |
攝護腺肥大(benign prostatic hyperplasia, BPH)是中老年男性最常見的良性腫瘤，也常因合併下泌尿道症狀(lower urinary tract symptoms, LUTS)而對生活品質造成嚴重影響。雖說目前認為造成攝護腺肥大的原因主要是和年齡以及荷爾蒙有相關，但其詳細的機轉仍非十分清楚。 有鑑於攝護腺肥大及下泌尿道症狀的重要性及普遍性，若能早期發現會造成攝護腺肥大及下泌尿道症狀進展(progression)的危險因子，並且能針對有這些危險因子的對象加以預防甚至治療就便成了相當重要的課題，雖說目前已經有不少這類相關的研究，但大多並非直接針對此一問題進行探討，且很多研究並沒有很好的研究設計。 Kok等人在2009年的Journal of Urology報告了他們利用Krimpen study的研究對象進行縱向研究(longitudinal study)的結果，研究對象是1688個50到78歲居住在社區的健康男性，追蹤時間是6.5年，主要是利用多變數分析來探討對原來國際攝護腺症狀評分(International Prostatic Symptoms Scores, IPSS)小於7分的男性，之後會有國際攝護腺症狀評分大於7分的危險因子。 研究結果發現除了年齡之外，有效膀胱容量(functional bladder capacity)，解尿後的殘尿量(post-void residual urine volume)，有沒有接受心臟疾病的治療(treatment for cardiac diseases)，教育程度(education level)，有無使用抗憂鬱藥物(antidepressant use)，有無使用鈣離子拮抗劑(calcium antagonist use)，勃起功能障礙(erectile function or dysfunction)，攝護腺特異抗原(prostate specific antigen)，以及有無攝護腺癌的家族史(family history of prostate cancer)都是會造成之後有國際攝護腺症狀評分大於7分的危險因子。 針對一個50歲的男性，若他有上述所有的危險因子，他在80歲時有八成的機會有下泌尿道症狀且國際攝護腺症狀評分達到七分以上而被診斷為攝護腺肥大。值得注意的是，即使沒有任何上述危險因子的健康男性，仍有三分之一的機會在50到80歲國際攝護腺症狀評分達到七分以上，因此並非所有造成攝護腺肥大的原因都能用上述危險因子來解釋。 此篇研究提供了我們一些對於健康的中老年男性，會造成攝護腺肥大及下泌尿道症狀進展(progression)的危險因子以及發生的機率，相信對大家在臨床面對病人時會有些許的幫助。 |
|
| abstract |
PURPOSE: We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in the open population. MATERIALS AND METHODS: A longitudinal, population based study with a followup of 6.5 years was done in 1,688 men who were 50 to 78 years old. Data were collected on transrectal ultrasound of prostate volume, urinary flow rate, ultrasound estimated post-void residual urine volume, generic and disease specific quality of life, and symptom severity based on the International Prostate Symptom Score. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were defined as an International Prostate Symptom Score of greater than 7 after a report of a score of less than 7 in the previous round. A multivariate Cox proportional hazard model was constructed to determine risk factors for clinical benign prostatic hyperplasia after correcting for patient age. RESULTS: Total followup was 4,353 person-years. During followup 180 events of attaining an International Prostate Symptoms Score of greater than 7 occurred. Multivariate analysis showed that functional bladder capacity, post-void residual urine volume, treatment for cardiac diseases, education level, antidepressant use, calcium antagonist use, erectile function or dysfunction, prostate specific antigen and a family history of prostate cancer were determinants with a significant HR. CONCLUSIONS: In addition to age, we established 9 significant determinants for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. However, not all risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia are accounted for since we can conclude that 1 of 3 men without these risk factors will still be diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia between ages 50 and 80 years. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||