McVary Kevin T
Northwestern University, Feinberg School of Medicine, Department of Urology, Chicago, IL 60611-3008, USA.
Am J Manag Care. 2006 Apr;12(5 Suppl):S122-8.
Recently published data suggest that clinical benign prostatic hyperplasia (BPH), which is hallmarked by the occurrence of moderate-to-severe lower urinary tract symptoms (LUTS), occurs in about one quarter of men in their 50s, one third of men in their 60s, and about half of all men 80 years or older. Although effective treatments for LUTS/BPH are available, this condition often occurs in the context of common, age-related comorbidities such as cardiovascular disease, hypertension, and erectile dysfunction. Alpha1-selective adrenergic receptor (a1-AR) antagonists (eg, alfuzosin, doxazosin, tamsulosin, terazosin) remain the cornerstone of therapy for LUTS/BPH. In addition, 5-alpha-reductase inhibitors (ie, dutasteride, finasteride) have been associated with improvements in LUTS/BPH in men with larger prostates, especially when used in combination with a1-AR antagonists. Although all these drugs have been shown to be beneficial for the treatment of BPH, there are differences in side-effect profiles. When selecting an appropriate course of therapy, these side effects and any impact they may have on existing comorbid conditions must be considered.
最近公布的数据表明，临床良性前列腺增生（BPH）以中度至重度下尿路症状（LUTS）的出现为特征，在50多岁的男性中约四分之一会发生，60多岁的男性中有三分之一会发生，80岁及以上的男性中约有一半会发生。尽管有针对LUTS/BPH的有效治疗方法，但这种疾病常发生在常见的、与年龄相关的合并症背景下，如心血管疾病、高血压和勃起功能障碍。α1选择性肾上腺素能受体（a1-AR）拮抗剂（如阿夫唑嗪、多沙唑嗪、坦索罗辛、特拉唑嗪）仍然是LUTS/BPH治疗的基石。此外，5-α还原酶抑制剂（即度他雄胺、非那雄胺）与前列腺较大的男性LUTS/BPH的改善有关，特别是与a1-AR拮抗剂联合使用时。尽管所有这些药物都已被证明对BPH治疗有益，但副作用情况存在差异。在选择合适的治疗方案时，必须考虑这些副作用及其对现有合并症可能产生的任何影响。
