高龄男性患者前列腺增生与肾功能的相关性研究

摘要

Objective To explore the relationship between benign prostatic hyperplasia and renal function in men aged 80 years and over.Methods Eighty-three clinical BPH patients (mean age of 85.8±4.7 years,range of 80-98 years) admitted to Geriatric Department of the First Affiliated Hospital of Zhengzhou University were recruited to this cross-sectional study from January 2017 to June 2017.They were grouped into treatment group (Gt,n=43) and non-treatment group (Gn,n=40) based on their choices for a therapy or observation.The prostate volume (PV) and post-void residual urine volume (PVR) were measured by abdominal ultrasound.A self-reported lower urinary tract symptoms (LUTS) was evaluated by International Prostate Symptoms Score (IPSS).An estimated glomerular filtration rate (eGFR) was calculated based on the serum level of creatinine and other indexes.Spearman and multiple linear regression analysis were applied to analyze correlations between BPH and renal function.Results The systolic and diastolic blood pressures were lower in Gt group than in Gn group (all P＜0.05).The PVR and IPSS were significantly lower in Gt group than in Gngroup[(28.9±16.6) ml vs.(67.3±32.8) ml;(18.2±9.1)vs.(24.7±10.3),all P＜0.05].The serum level of creatinine was lower in Gt group [(73.7±16.3) μmol/L] than in Gn group [(85.4±19.8) μmol/L] (P＜0.05).The eGFR was higher in Gt group[(77.2±11.4) ml · min 1 ·1.73 m-2] than in Gn group[(69.8±13.9) ml · min 1 · 1.73 m-2] (P＜0.05).No statistical differences were observed in PV between Gt group[(24.6 ± 11.4) ml] and Gn group[(27.0 ± 20.8) ml] (P＞0.05).Spearman relation analysis showed that creatinine level was negatively correlated with treatment for BPH (r=-0.337,P＜0.05).Multiple linear regression analysis showed that non-receiving of treatments for BPH was an independent risk factor for an increased creatinine level(r=-0.349,t=-2.802,P＜0.01).Conclusions For men aged 80 years and over,BPH is associated with decreased eGFR,and the treatment for BPH may improve renal function.%目的 观察高龄男性患者前列腺增生与肾功能的关系. 方法 横断面研究,连续入选2017年1-6月在郑州大学第一附属医院老年科住院的良性前列腺增生患者83例为观察对象,根据是否接受前列腺增生相关治疗分为治疗组43例与非治疗组40例,以血压、前列腺体积、残余尿量、国际前列腺症状评分(IPSS)、血肌酐及肾小球率过滤估计值(eGFR)为观察指标.Spearman、多元线性回归分析前列腺增生与肾功能的相关性. 结果 治疗组患者前列腺体积小于未治疗组,(24.6±11.4)ml比(27.0±20.8)ml(P＞0.05);残余尿量、IPSS低于未治疗组,(28.9±16.6)ml比(67.3±32.8)ml、(18.2±9.1)分比(24.7±10.3)分(均P＜0.05);血肌酐低于未治疗组,(73.7±16.3) tmol/L比(85.4±19.8)μmol/L(P＜0.05);eGFR高于未治疗组,(77.2±11.4)ml· min-1·1.73 m-2比(69.8±13.9)ml·min-1·1.73 m-2(P＜0.05).相关分析结果显示,肌酐水平与是否治疗呈负相关(r=-0.337,P＜0.05),是否接受前列腺增生相关治疗是影响肌酐水平的独立危险因素(π=-2.802,P＜0.01). 结论 高龄男性患者前列腺增生与肾功能进展相关,积极治疗前列腺增生可改善肾功能.