良性前列腺增生临床进展与代谢综合征各成分的回归模型研究

摘要

目的 分析代谢综合征(MS)各成分对老年人良性前列腺增生(BPH)临床病程进展的影响因素.方法 将155例BPH患者根据是否患MS分为单纯BPH组(n=86)和BPH合并MS组(n=69),分析2组各代谢指标和BPH指标的差异；分别以BPH患者的前列腺体积(TPV)、残余尿量、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、血清前列腺特异性抗原(PSA)、前列腺年增长率为因变量,以MS各成分为自变量,进行多元线性回归分析.结果 单纯BPH组与BPH合并MS组比较,BPH患者的病程进展观察指标PSA、TPV、Qmax、IPSS、前列腺年增长率等的差异均有统计学意义(P＜0.05).多元线性回归显示,与TPV正相关的成分为空腹血糖、胰岛素抵抗指数、腰围(P＜0.05)；与残余尿量正相关的成分为胰岛素抵抗指数(P＜0.05)；与Qmax负相关的成分为胰岛素抵抗指数(P＜0.01)；与IPSS评分正相关的成分为体重指数(P＜0.01)、空腹血糖、腰围(P＜0.05)；与PSA正相关的成分为空腹血糖(P＜0.05),与前列腺年增长率正相关的成分为空腹血糖、空腹胰岛素(P＜0.05).结论 针对MS中的不同成分,各个BPH临床进展指标各有其独立的影响因素,针对BPH患者不同的临床指标,应采取不同的治疗方案.%Objective To explore the clinical progression factors for the metabolic syndrome (MS) on elderly benign prostatic hyperplasia (BPH).Methods A total of 155 elderly BPH were divided into two groups:simple BPH (n =86) and BPH with MS (n =69) groups,the differences of the metabolic and BPH index between two groups were compared.By multiple linear regression,the effects and correlation of prostate volume (TPV),residual urine volume,Qmax,intemational prostate symptom score (IPSS),prostate-specific antigen (PSA),and annual prostate growth rate with various components of MS were analyzed.Results There were statistical differences (P ＜ 0.05) on TPV,Qmax,IPSS,PSA,and annual prostate growth rate between BPH and BPH with MS groups.The multiple linear regression showed that the TPV has a significantly positive correlation with FBG and HOMA-IR.Residual urine volume showed a significantly positive correlation with HOMA-IR.Qmax has a significantly negative correlation with HOMA-IR.IPSS has a significantly positive correlation with BMI,FBG and waist circumference.PSA has a significantly positive correlation with FBG.Annual prostate growth rate has a significantly positive correlation with FBG and FINS.Conclusion MS has evident effects on the development of BPH.