Lepor H
Department of Urology, Medical College of Wisconsin, Milwaukee 53226.
Prostate Suppl. 1990;3:75-84. doi: 10.1002/pros.2990170508.
The dynamic component of infravesical obstruction in men with symptomatic benign prostatic hyperplasia (BPH) is determined by alpha 1-adrenoceptor-mediated contractions of the prostatic capsule, prostate adenoma, and bladder neck. Since alpha 1-adrenoceptors are sparse in the bladder, medical therapy aimed at blocking the alpha receptor will relieve bladder outlet obstruction without inhibiting bladder function. Numerous clinical studies have evaluated the use of various alpha blockers for the treatment of BPH. Although the majority of these trials involved limited numbers of patients treated for only short periods, their results have consistently shown that alpha blockers improve urinary flow rates. Adverse reactions appear to be more frequent and more serious with the use of nonselective alpha blockers than with selective alpha 1 blockers, such as terazosin or prazosin. Terazosin offers the additional advantage of once-daily dosing. The common association of hypertension, hyperlipidemia, and symptomatic BPH in the aging male population may provide further impetus for initiating treatment with alpha blockers because alpha blockers are effective antihypertensive agents and may favorably alter lipid profiles.
有症状的良性前列腺增生（BPH）男性患者膀胱下梗阻的动态成分，由前列腺包膜、前列腺腺瘤和膀胱颈的α1肾上腺素能受体介导的收缩所决定。由于膀胱中α1肾上腺素能受体稀少，旨在阻断α受体的药物治疗将缓解膀胱出口梗阻而不抑制膀胱功能。众多临床研究评估了各种α受体阻滞剂用于治疗BPH的情况。尽管这些试验大多涉及治疗时间短且患者数量有限，但结果一致表明α受体阻滞剂可提高尿流率。与使用选择性α1受体阻滞剂（如特拉唑嗪或哌唑嗪）相比，使用非选择性α受体阻滞剂时不良反应似乎更频繁、更严重。特拉唑嗪还具有每日一次给药的额外优势。老年男性人群中高血压、高脂血症与有症状的BPH常同时存在，这可能为开始使用α受体阻滞剂治疗提供进一步的推动因素，因为α受体阻滞剂是有效的抗高血压药物，可能会有利地改变血脂谱。
