Hanai Tadashi, Matsumoto Seiji, Shouji Sunao, Usui Yukio, Tang Xian Yan, Kato Yoshinari, Iguchi Masanori, Uemura Hirotsugu, Terachi Toshirou
Urological and Urodynamics Center, Koushinkai Hospital.
Hinyokika Kiyo. 2009 Apr;55(4):187-91.
The aims of this study were to define the relationships between prostate-specific antigen (PSA) and alpha 1-adrenergic receptor antagonist (alpha 1 blocker). A prospective clinical study of 48 male patients examined between May 2004 and December 2007 was performed. 4.0-9.9 ng/ml PSA level who had no notable clinical findings of urinary retention, urinary tract infections and prostate cancer (PC) received tamusulosin 0.2 mg once daily for 3 months, and then received prostate biopsy. We divided the patients into two groups: PC and benign prostate hyperplasia (BPH)/lower urinary tract symptom (LUTS) group. In total, the PSA level showed no significant change after treatment. In the PC group, PSA significantly increased after treatment. However, PSA decreased in the BPH/LUTS group. The alpha 1 blocker significantly improved urination status (the subjective symptoms and urodynamics parameters) in the BPH/LUTS group. In two groups, prostate volume showed no significant difference. Among those patients in the BPH/LUTS group, their urination status was significantly improved with alpha 1 blocker and their PSA level dropped slightly. On the other hand, the PSA level was significantly increased in the PC group. This study shows that by using an alpha 1 blocker, it may be possible to avoid conducting the prostate biopsy at an early stage or indeed one may not be needed at all for patients with only slight increases in PSA.
本研究的目的是确定前列腺特异性抗原(PSA)与α1肾上腺素能受体拮抗剂(α1阻滞剂)之间的关系。对2004年5月至2007年12月间检查的48例男性患者进行了一项前瞻性临床研究。PSA水平在4.0 - 9.9 ng/ml且无尿潴留、尿路感染和前列腺癌(PC)显著临床发现的患者,每天服用一次0.2 mg坦索罗辛,持续3个月,然后进行前列腺活检。我们将患者分为两组:PC组和良性前列腺增生(BPH)/下尿路症状(LUTS)组。总体而言,治疗后PSA水平无显著变化。在PC组中,治疗后PSA显著升高。然而,在BPH/LUTS组中PSA降低。α1阻滞剂显著改善了BPH/LUTS组的排尿状况(主观症状和尿动力学参数)。两组间前列腺体积无显著差异。在BPH/LUTS组的患者中,α1阻滞剂显著改善了他们的排尿状况,且他们的PSA水平略有下降。另一方面,PC组的PSA水平显著升高。本研究表明,对于PSA仅略有升高的患者,使用α1阻滞剂可能可以避免早期进行前列腺活检,甚至可能根本不需要活检。