Milroy E
Department of Urology, Middlesex Hospital, London, UK.
Urol Int. 1990;45 Suppl 1:1-3. doi: 10.1159/000282022.
Prazosin is well known to most physicians as an effective antihypertensive medication, but its therapeutic value in many cases of benign prostatic hyperplasia (BPH) may be unfamiliar to many. Prostate problems are among the most common medical conditions facing older men, with BPH appearing in more than 50% of men over the age of 50 years and in 90% of those over 80 years of age. About 10% of men over the age of 40 undergo surgery for the condition. Research in the past 15 years has revealed that smooth muscle contractions in the enlarged prostate are controlled by stimulation of the alpha 1-receptors in the tissue. This discovery has provided the rationale for administering drugs to block the stimulation of the alpha 1-receptors to relieve the obstructive and irritative symptoms of BPH. Prazosin was an early candidate for such medication because of its highly selective alpha 1-blockade and its well-documented safety record. Early clinical trials yielded convincing evidence of prazosin's effectiveness in reducing BPH symptoms, and the number of patients treated with prazosin for BPH now numbers in the several hundreds. In these trials, prazosin administered in doses from 1 mg to as high as 9 mg a day relieved obstructive and irritative symptoms, as well as improved flow rates and decreased urethral pressure. Overall, between 60 and 70% of treated patients can be expected to enjoy real benefits from prazosin therapy.
大多数医生都熟知哌唑嗪是一种有效的抗高血压药物，但它在许多良性前列腺增生（BPH）病例中的治疗价值可能很多人并不熟悉。前列腺问题是老年男性面临的最常见的医疗状况之一，50岁以上的男性中超过50%患有BPH，80岁以上的男性中这一比例为90%。40岁以上的男性中约有10%因该疾病接受手术治疗。过去15年的研究表明，前列腺增生组织中的平滑肌收缩受组织中α1受体刺激的控制。这一发现为使用药物阻断α1受体刺激以缓解BPH的梗阻性和刺激性症状提供了理论依据。哌唑嗪因其高度选择性的α1阻断作用和有充分记录的安全记录，是这类药物的早期候选药物。早期临床试验产生了令人信服的证据，证明哌唑嗪在减轻BPH症状方面有效，目前用哌唑嗪治疗BPH的患者人数达数百人。在这些试验中，每天服用1毫克至高达9毫克剂量的哌唑嗪可缓解梗阻性和刺激性症状，提高尿流率并降低尿道压力。总体而言，预计60%至70%接受治疗的患者能从哌唑嗪治疗中真正获益。
