精索静脉曲张对老年男性良性前列腺增生症发病的影响

摘要

目的：研究精索静脉曲张（varicocele，VC）与良性前列腺增生（benign prostatic hyperplasia ， BPH）发病的关系。方法：2013年1月至12月我科诊断为良性前列腺增生的患者共120例，年龄51～80岁。根据有无精索静脉曲张，划分为伴 VC 的 BPH 组61例，无 VC 的 BPH 组59例。同期无 VC 无 BPH 的青年猝死者20例作为阴性对照组。记录实验组患者前列腺体积、IPSS 评分、残余尿、最大尿流率（Qmax），测定各组被观察者血清睾酮水平、前列腺组织内睾酮水平及雄激素受体表达情况。结果：两 BPH 组患者血清睾酮水平与对照组的对比差异有统计学意义（P ＜0.05）。前列腺组织内，VC 伴 BPH 组睾酮水平最高，雄激素受体表达最高（P ＜0.05）。VC 发生与前列腺体积、IPSS 评分、残余尿正相关（r ＝0.29、0.31、0.09，均 P ＜0.01），与最大尿流率负相关（r ＝0.41，P ＜0.01）。结论：精索静脉曲张在良性前列腺增生发病及发展中起着重要作用。%Objectives:To investigate the relationship of benign prostatic hyperplasia (BPH)with varico-cele (VC).Methods:120 BPH men,61 with VC and 59 without VC,were enrolled as BPH group,and 20 young sudden death men without VC were enrolled as control group.The levels of prostate volume,IPSS,residual urine, Qmax were recorded.The levels of testosterone in serum and in prostate tissue,and androgen receptor in prostate tissue were detected.Results:Significant differences were found between BPH group and the control group in the serum testosterone level (P <0.05).In prostate tissue,there were higher level of testosterone and androgen recep-tor in VC with BPH group (P <0.05).VC was positively related with prostate volume,IPSS and residual urine, while negatively related with Qmax (P <0.01).Conclusion:Varicocele plays an important role in the occurence and development of benign prostatic hyperplasia.