Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia (BPH) in elderly patients with metabolic syndrome (MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group (n=45,40 mg/d),atorvastatin group (n=45,20 mg/d) and control group (n=45).BMI,waist circumference,blood pressure,levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL C),high sensitivity C-reactive protein (hs-CRP),interleukin 6 (IL-6),testosterone,estradiol,prostate specific antigen (PSA) and international prognostic scoring system (IPSS) and prostate volume were detected before and 12 months after treatment.Results Compared with control group,patients receiving simvastatin or atorvastatin for 12 months showed that the levels of serum TC,TG,LDL-C,hs-CRP,IL-6,IPSS were decreased(all P＜0.05),the level of serum HDL-C level were increased (all P＜0.05),and prostate volume was reduced(P＜0.05).The decrease in prostate volume was more in patients receiving simvastatin than receiving atorvastatin [(10.86±5.65) ml vs.(5.91 ± 3.03)ml,P＜0.05].Multiple stepwise regression analysis showed that the reduction of prostate volume was positively related to the decreases of serum TC and IL-6 levels,and to the increase of serum HDL-C level.Conclusions Simvastatin and atorvastatin have the efficacy reducing prostate volume and improving obstruction symptoms of lower urinary tract,and slowing the clinical progression of BPH and simvastatin is more effective than atorvastatin on reducing prostate volume.The efficacies of statins might be through lowering cholesterol level and antiinflammatory effect.%目的 探讨辛伐他汀和阿托伐他汀对老年良性前列腺增生(BPH)合并代谢综合征(MS)患者BPH临床进展的治疗作用. 方法 应用随机对照方法,将年龄≥60岁BPH合并MS患者135例随机分为对照组(45例)、辛伐他汀组(45例,40 mg/d)和阿托伐他汀组(45例,20 mg/d).干预前和干预12个月后分别检测体质指数(BMI)、腰围、血压、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、睾酮、雌二醇、前列腺特异性抗原(PSA)水平、国际前列腺症状评分(IPSS)及前列腺体积. 结果 (1)与对照组比较,12个月后辛伐他汀组和阿托伐他汀组TG、TC、LDL-C水平明显下降(P＜0.05),HDL-C水平明显升高(P＜0.05),hs CRP、IL-6水平明显下降(P＜0.05),IPSS评分及前列腺体积也明显下降(P＜0.05).前列腺体积缩小程度辛伐他汀组为(10.86±5.65)ml,阿托伐他汀组为(5.91±3.03)ml,差异有统计学意义(P=0.049).(2)多元逐步回归分析发现,他汀类干预前后TC、IL-6水平的下降及HDL C水平的升高与前列腺体积缩小明显相关(t=2.437,2.463,-2.952,均P＜0.05),即TC、IL-6水平的下降程度越大及HDL-C水平的升高程度越大,则前列腺体积缩小越明显. 结论 辛伐他汀和阿托伐他汀治疗对BPH合并MS老年人有缩小前列腺体积、改善下尿路梗阻症状的作用,其中辛伐他汀缩小前列腺体积的作用较阿托伐他汀明显.他汀药物可能通过调脂、抗炎等机制起到延缓前列腺增生临床进展的作用.
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