老年患者代谢综合征与良性前列腺增生术后复发的相关性研究

摘要

Objective To investigate the relationship between metabolic syndrome (MS) and early recurrence of benign prostatic hyperplasia (BPH) after prostatectomy in the elderly.Methods A total of 152 men aged 65 to 88 years with prostatectomy for more than 5 years were enrolled from August 2008 to March 2013.Blood pressure,body weight,body height,body mass index (BMI) and international prostate symptom score (IPSS) were detected.Levels of fasting blood glucose (FBG),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),prostate specific antigen (PSA) and maximum urinary flow rate (Qmax) were determined.The correlation of MS-related parameters with prostate volume,IPSS and Qmax were evaluated.Results BPH recurrence rate was significantly higher in patients with MS than without MS (11/26 vs.27/126,x2=12.76,P＜0.001).PSA level,prostate volume and IPSS were significantly higher or larger in the MS group than in the non-MS group [(1.96±0.82)μg/L vs.(1.81±0.90)μg/L,(28.26±5.50) ml vs.(22.38±4.00)ml,(11.12±3.18)vs.(7.11±2.37),F=28.654,44.41,38.56,respectively,P＜0.001],while Qmax value was significantly lower in the MS group than in the non-MS group [(14.77±5.29) ml/s vs.(19.80±4.70) ml/s,F=59.48,P＜0.001].The liner regression analysis showed that in postprostatectomy recurrence group,PV and IPSS had significantly positive correlations with levels of FBG and TG,and BMI (P＜0.05),and had significantly positive correlations with BMI and FBG in non-recurrence group (P＜0.05),while Qmax had a significantly negative correlation with BMI,systolic blood pressure and FBG in the two groups (P＜0.05).Conclusions There is a significant relationship between MS and higher BPH recurrence in elderly patients.%目的 探讨代谢综合征与老年患者良性前列腺增生(BPH)术后早期复发的相关性.方法 选择2008年8月至2013年3月在我院体检中心进行查体的BPH切除术后5年以上65～88岁患者152例,测量患者血压、体质量、身高,体质指数(BMI)、前列腺症状评分,生化分析包括晨空腹血糖(FGB)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血前列腺特异抗原(PSA),同时行尿常规分析、最大尿流率(Qmax)测定,评估代谢综合征各相关指标与前列腺体积(PV)、国际前列腺症状(IPSS)评分、Qmax的相关性. 结果 伴代谢综合征的26例患者BPH术后复发11例,无代谢综合征患者126例术后复发27例,伴代谢综合征者BPH术后复发率明显高于对照组(x2=12.76,P=0.000).伴代谢综合征组患者血PSA值、PV、IPSS评分分别为(2.0±0.8)μg/L、(28.3±5.5)ml、(11.1±3.2)分,显著高于无代谢综合征患者(1.8±1.0)μg/L、(22.4±4.0)ml、(7.1±2.4)分(t=28.65、44.41、38.56,P=0.000、0.000、0.000),最大尿流率(14.8±5.3)ml/s,显著小于无代谢综合征患者(19.8±4.7)ml/s(t=59.48、P=0.000).BPH术后复发组患者PV、IPSS评分与BMI、FGB、TG呈显著正相关(均P＜0.05),BPH术后无复发组患者PV、IPSS评分与BMI、FGB呈显著正相关(均P＜0.05),两组患者Qmax与BMI、收缩压、FGB均呈显著负相关(P＜0.05). 结论 代谢综合征与老年患者BPH术后复发率增加有明显的相关性.