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下尿路症状与生活方式因素以及前列腺良性增生和梗阻客观指标之间的关系:一项意大利调查。

The relation of lower urinary tract symptoms with life-style factors and objective measures of benign prostatic enlargement and obstruction: an Italian survey.

作者信息

Tubaro Andrea, La Vecchia Carlo

机构信息

Department of Urology, Sant'Andrea Hospital, 2nd School of Medicine, La Sapienza University of Rome, Rome, Italy.

出版信息

Eur Urol. 2004 Jun;45(6):767-72. doi: 10.1016/j.eururo.2004.01.011.

Abstract

OBJECTIVES

The association between the severity of LUTS and prostate volume, prostate-related variables and general life-style factors was investigated in a large number of patients with persistent LUTS suggestive of BPH (LUTS/BPH).

METHODS

Patients with LUTS/BPH aged between 50 and 80 years, were enrolled in this Italian, multicentre, observational study. The total, storage and voiding I-PSS and I-PSS-QoL index were collected, prostate volume and urodynamic variables measured. Multiple logistic regression equations were used to obtain the odds ratio (and 95% confidence interval) of moderate plus severe I-PSS (>7) versus mild I-PSS (< or =7, reference category), with allowance for age stratification, whenever indicated.

RESULTS

In total, 802 patients were evaluated. The strongest association was found between the total I-PSS and the QoL. There was a slightly increased risk to suffer from more severe LUTS with increasing age. A significant increase risk of developing storage symptoms was found in older patient cohorts. Decrease of Q(max) values, increase of Abrams-Griffith number, serum PSA levels and prostate volume as judged by digital rectal examination were significantly associated to a higher risk of developing LUTS. No association was found between symptom severity and prostate volume or post-voiding residual, estimated by ultrasound.

CONCLUSIONS

No significant association between severity of LUTS and life-style factors was observed. An increased risk of developing LUTS was found in patients with lower maximum flow rate and in those with higher PSA values. The association between LUTS and prostate volume remains questionable.

摘要

目的

在大量提示良性前列腺增生(LUTS/BPH)的持续性下尿路症状患者中,研究下尿路症状严重程度与前列腺体积、前列腺相关变量及一般生活方式因素之间的关联。

方法

年龄在50至80岁之间的LUTS/BPH患者被纳入这项意大利多中心观察性研究。收集了总I-PSS、储尿期和排尿期I-PSS以及I-PSS-QoL指数,测量了前列腺体积和尿动力学变量。使用多元逻辑回归方程,在有指征时按年龄分层,获得中度加重度I-PSS(>7)与轻度I-PSS(≤7,参照类别)相比的比值比(及95%置信区间)。

结果

总共评估了802例患者。发现总I-PSS与QoL之间的关联最强。随着年龄增长,患更严重下尿路症状的风险略有增加。在老年患者队列中,出现储尿期症状的风险显著增加。通过直肠指检判断,Q(max)值降低、Abrams-Griffith数增加、血清PSA水平和前列腺体积增加与发生下尿路症状的较高风险显著相关。未发现症状严重程度与经超声估计的前列腺体积或排尿后残余尿量之间存在关联。

结论

未观察到下尿路症状严重程度与生活方式因素之间存在显著关联。最大尿流率较低的患者和PSA值较高的患者发生下尿路症状的风险增加。下尿路症状与前列腺体积之间的关联仍存在疑问。

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