Sarma Aruna V, McLaughlin Julie C, Jacobsen Steven J, Logie John, Dolin Paul, Dunn Rodney L, Cooney Kathleen A, Montie James E, Schottenfeld David, Wei John T
Department of Urology, University of Michigan Health System, Ann Arbor, Michigan 48109-0759, USA.
Urology. 2004 Nov;64(5):959-65. doi: 10.1016/j.urology.2004.06.043.
To examine the progression of lower urinary tract symptoms in a longitudinal population-based cohort of black men. Population-based studies of prostatism and longitudinal data regarding changes in lower urinary tract symptom severity have largely focused on white men, with little attention directed toward black men.
In 1996, a probability sample of 369 black men, aged 40 to 79 years, residing in Genesee County, Michigan, and without a prior history of prostate cancer/surgery participated in a prostate cancer screening protocol that included completing the American Urological Association Symptom Index (AUASI). Four years after baseline, 175 of the 369 men agreed to participate in the follow-up protocol. Of the 175 men, 149 had not reported undergoing treatment for benign prostatic hyperplasia and had complete symptom data. These men were included in this study. Differences between baseline and follow-up AUASI scores were examined.
The mean and standard deviation AUASI scores at baseline and follow-up were 7.1 (6.4) and 7.0 (6.8), respectively. Although overall no statistically significant change was found in the mean AUASI during the 4 years of follow-up (-0.11; SD 6.2; P = 0.7), the average change in the symptom score and the variability in the change increased with patient age at baseline from a mean of -0.42 (SD 5.0) among men in their 40s to 2.1 (SD 6.6) among men in their 70s. Of the 91 men (61.1%) who reported mild to no symptoms (AUASI score 7 or less) at baseline, 24 (26.4%) reported moderate to severe symptoms (AUASI score 8 or more) at follow-up. This progression of symptom severity was observed across all ages.
In this population-based study of longitudinal changes in urinary symptoms in black men, we found a substantial percentage of men demonstrated a measurable progression in urinary symptom severity over time. Additional studies are needed to examine critically any racial differences in lower urinary tract symptom progression.
在一个基于人群的黑人男性队列中研究下尿路症状的进展情况。关于前列腺增生的基于人群的研究以及有关下尿路症状严重程度变化的纵向数据，大多聚焦于白人男性，很少关注黑人男性。
1996年，从居住在密歇根州杰纳西县、年龄在40至79岁之间且无前列腺癌/手术既往史的黑人男性中，抽取369名作为概率样本，参与一项前列腺癌筛查方案，其中包括完成美国泌尿外科学会症状指数（AUASI）。基线4年后，369名男性中有175名同意参与随访方案。在这175名男性中，149名未报告接受过良性前列腺增生治疗且有完整的症状数据。这些男性被纳入本研究。对基线和随访时的AUASI评分差异进行了检查。
基线和随访时AUASI评分的均值及标准差分别为7.1（6.4）和7.0（6.8）。尽管在4年随访期间平均AUASI未发现有统计学意义的变化（-0.11；标准差6.2；P = 0.7），但症状评分的平均变化以及变化的变异性随基线时患者年龄增加而增大，从40多岁男性的平均-0.42（标准差5.0）增至70多岁男性的2.1（标准差6.6）。在基线时报告有轻度至无症状（AUASI评分7分及以下）的91名男性（61.1%）中，24名（26.4%）在随访时报告有中度至重度症状（AUASI评分8分及以上）。在所有年龄段均观察到了这种症状严重程度的进展。
在这项关于黑人男性尿路症状纵向变化的基于人群的研究中，我们发现相当比例的男性随着时间推移尿路症状严重程度有可测量的进展。需要进一步研究来严格审视下尿路症状进展方面的任何种族差异。
