加入會員 會員登入 聯絡我們English

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。
發表人 討論主題 發表時間 討論數
吳冠諭 戒菸救膀胱 —— 攝護腺肥大患者戒菸時間長短和慢性攝護腺炎症狀及膀胱過動症狀呈負相關 2020/12/31 下午 04:27:32 0
原 文 題  目 Duration of smoking cessation is negatively associated with the magnitude of chronic prostatic inflammation and storage dysfunction in patients with benign prostatic hyperplasia.
作  者 So Inamura, Hideaki Ito, Hideki Oe, Masaya Seki, Minekatsu Taga, Motohiro Kobayashi and Osamu Yokoyama
出  處 International Journal of Urology
出版日期 24 July, 2020
評 論

香菸內含多種化學物質,根據之前的研究,抽菸會增加心血管疾病的風險,中樞神經系統的損傷,以及男性性功能的退化,但抽菸對於排尿功能會不會有所影響呢?本文是日本福井大學的研究,共收錄118位攝護腺雷射手術術後的男性病人進行分析,其中有45位非吸菸者,62位曾吸菸者,以及11位正在吸菸者。所有病人都有接受國際攝護腺症狀評分表(IPSS),壓力尿流速檢測,尿流速檢查,以及攝護腺雷射手術。
本文先是針對非吸菸者和吸菸者(包括曾吸菸者和現在正在吸菸者)進行比較,發現國際攝護腺症狀評分表(IPSS)的症狀評分顯示,吸菸者呈現比非吸菸者嚴重的趨勢。
在抽菸者的分析中發現,持續抽菸時間的長短在壓力尿流速的測試中可看出明顯差異。持續抽菸時間越長的人,在壓力尿流速的測試中產生尿急感以及逼尿肌過動的症狀較為明顯。反之,戒菸時間越久的人,在壓力尿流速的測試中產生尿急感的狀況則較輕微。若以戒菸時間20年為界,戒菸時間超過20年的人發生急性尿滯留的比例顯著較低。
同時本研究也透過血液及攝護腺檢體分析,研究攝護腺發炎和抽菸的關係,結果發現,抽菸時間越長的人血中發炎指數越高。同時也發現戒菸時間越長,攝護腺組織發炎的程度越輕微。
但是,吸菸為什麼會跟頻尿,尿急感,甚至攝護腺發炎扯上關係呢?本文推測是因為香菸中含有大量化學物質以及自由基,長期吸菸會導致血管內皮細胞受損,進而傷害膀胱血流,誘發逼尿肌過度收縮而產生膀胱過動等下泌尿道症狀。
雖然抽菸和下泌尿道症狀以及膀胱過動症的關聯性還需要更多的研究來佐證,但從本文可以告訴我們,癮君子如果戒菸的話,對於下泌尿道症候群以及膀胱過動症可能會有所幫助喔,為了不要一直勤跑廁所,戒菸也許會提供意想不到的效果呢。

abstract Objectives
To evaluate the impact of smoking and the benefit of smoking cessation on lower urinary tract function and prostatic inflammation in patients with benign prostatic hyperplasia.

Materials and Methods
The medical records of 118 benign prostatic hyperplasia patients who underwent transurethral prostatic surgery between 2006 and 2016 were analyzed. Their smoking history was confirmed. The relationship between smoking and main clinical parameters, International Prostate Symptom Scores, uroflowmetry, pressure flow study, magnitude of prostatic inflammation and the level of serum C-reactive protein was investigated. Furthermore, the relationships between smoking cessation and these clinical parameters were assessed.

Results
The International Prostate Symptom Scores for straining among the nonsmokers were significantly lower than those of the smokers (1.71 vs 2.60, P = 0.029). In the pressure flow study, there were negative correlations between the duration of smoking and strong desire to void (correlation coefficient _0.314, P = 0.013), urgency (correlation coefficient _0.349, P = 0.008) and bladder volume at initial detrusor overactivity (correlation coefficient _0.417, P = 0.021). The duration of smoking cessation was negatively correlated with the magnitude of chronic prostatic inflammation (correlation coefficient _0.253, P = 0.027). In the pressure flow study, the duration of smoking cessation was positively correlated with urgency (correlation coefficient 0.286, P = 0.030) and maximum cystometric capacity (correlation coefficient 0.241, P = 0.050).

Conclusion
Smoking could be a risk factor for the exacerbation of storage dysfunction in benign prostatic hyperplasia patients. Smoking cessation is effective in improving chronic prostatic inflammation and storage dysfunction.

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