Objective To observe the clinical effect of finasteride on patients with benign prostate hyperplasia(BPH) after transurethral resection of prostate(TURP);to investigate influence factors of prognosis of BPH.Methods A retrospective study was conducted on 241 patients with BPH after TURP in Beijing Anzhen Hospital,Capital Medical University from January 2011 to December 2015.The patients were divided into drug intervention group(76 cases,finasteride 5 mg/d orally) and blank control group(165 cases,without drug intervention).Observation targets included age,metabolic syndrome(MS),body mass index(BMI),prostate volume(PV) and the International Prostate Symptom Score (IPSS).Changes of PV and IPSS were recorded during 1 year follow-up since 1 month after TURP.Influence factors of PV and IPSS were analyzed by multiple linear regression analysis.Results There were 126 cases (76.4％) of MS in blank control group and 57 cases (75.0％) of MS in drug intervention group;the incidence of MS had no significant difference between groups (P ＞ 0.05).There were no significant differences of age,BMI,postoperative 1 month PV and IPSS between groups (P ＞ 0.05).The postoperative 13 month PV was significantly larger than the postoperative 1 month PV in blank control group;the postoperative 13 month PV,IPSS in drug intervention group were significantly smaller than the postoperative 1 month ones and those in blank control group[22.6(19.8,23.8)ml vs 19.4(17.9,21.6);18.6(17.3,20.0)ml vs 19.3(17.9,21.6),22.6(19.8,23.8)ml;10.0(9.0,11.0)scores vs 13.0(11.0,14.0),12.0(10.0,13.0)scores] (P＜0.05).Multiple linear regression analysis showed that postoperative 1 month PV,BMI and administration of finasteride were influence factors of postoperative 13 month PV(odds ratio =0.562,0.128,-0.556;P ＜0.05);postoperative 1 month IPSS and administration of finasteride were influence factors of postoperative 13 month IPSS(odds ratio =0.584,-0.522;P ＜ 0.05).Conclusions One year oral administration of finasteride after TURP helps control residual volume of prostate gland and alleviate lower urinary tract symptoms.Early postoperative PV,BMI and administration of finasteride have influence on prognosis of BPH.%目的 探讨良性前列腺增生症(BPH)患者经尿道前列腺电切术(TURP)后服用非那雄胺的临床效果及病症相关影响因素.方法 选取2011年1月至2015年12月首都医科大学附属北京安贞医院TURP后的BPH患者241例进行回顾性研究.根据术后是否辅以药物干预分为药物干预组(76例,给予非那雄胺5 mg/d口服),空白对照组(165例,未予药物干预).随访从TURP后第1个月开始,研究指标包括年龄、是否发生代谢综合征(MS)、体重指数、前列腺体积(PV)及国际前列腺症状评分(IPSS)等.记录TURP后第1、13个月IPSS和PV,进行组间比较并应用多元线性回归分析TURP后PV及IPSS进展的影响因素.结果 空白对照组126例(76.4％)患MS,药物干预组57例(75.0％)患MS,差异无统计学意义(P＞0.05).药物干预组与空白对照组年龄、体重指数、术后1个月PV、IPSS差异无统计学意义(P＞0.05).空白对照组术后13个月PV大于本组术后1个月,药物干预组术后13个月PV、IPSS小于本组术后1个月及空白对照组同时点,差异均有统计学意义[22.6(19.8,23.8) ml比19.4(17.9,21.6),18.6(17.3,20.0)ml比19.3(17.9,21.6)、22.6(19.8,23.8)ml,10.0(9.0,11.0)分比13.0(11.0,14.0)、12.0(10.0,13.0)](均P＜0.05).多元线性回归分析结果显示,TURP后1个月PV、体重指数及服用非那雄胺是TURP后13个月PV大小的影响因素(比值比=0.562、0.128、-0.556,均P＜0.05);TURP后1个月IPSS及服用非那雄胺是TURP后13个月IPSS的影响因素(比值比=0.584、-0.522,均P＜0.05).结论 BPH患者TURP后继续服用非那雄胺1年可以进一步控制残存腺体体积,改善下尿路症状.前期PV、体重指数、服用药物影响后期病症.
展开▼
