University of North Carolina Division of Urologic Surgery, Chapel Hill, NC, USA.
Ther Clin Risk Manag. 2009 Jun;5(3):535-45. doi: 10.2147/tcrm.s6195. Epub 2009 Jul 12.
Benign prostatic hyperplasia (BPH) is a complex and progressive disease common in aging men. While associated with bothersome lower urinary tract symptoms, it may also result in additional serious complications such as refractory hematuria, acute urinary retention, and BPH-related surgery. Medical therapy has been offered as an approach to halt this progression and perhaps reverse the pathophysiology of BPH. While alpha-blockers provide rapid relief in the form of improved flow rate, their effects may not reduce the overall risk of BPH-related complications. 5alpha-reductase inhibitors were therefore introduced to affect the underlying disease process by inhibiting the enzyme which converts testosterone to dihydrotesterone, the primary androgen involved in normal and abnormal prostate growth. Through this inhibition, prostate size is decreased, thereby reducing the risk of acute urinary retention and BPH-related surgery while providing symptom control. These effects are most pronounced in men with enlarged prostates (>25 mL) who are at the greatest risk of disease progression. This article reviews the literature for finasteride used in the treatment of BPH and provides evidence for its efficacy, safety and tolerability, applicability for combination therapy, and considerations of its effects on prostate cancer risk.
良性前列腺增生症（BPH）是一种常见于老年男性的复杂且进行性疾病。虽然它与令人烦恼的下尿路症状有关，但它也可能导致其他严重的并发症，如难治性血尿、急性尿潴留和与 BPH 相关的手术。已经提供了医学治疗作为阻止这种进展并可能逆转 BPH 病理生理学的方法。虽然 α-受体阻滞剂通过改善流速提供了快速缓解，但它们的效果可能不会降低与 BPH 相关并发症的总体风险。因此，引入了 5α-还原酶抑制剂通过抑制将睾丸激素转化为二氢睾丸酮的酶来影响潜在的疾病过程，二氢睾丸酮是参与正常和异常前列腺生长的主要雄激素。通过这种抑制，前列腺体积减小，从而降低急性尿潴留和与 BPH 相关手术的风险，同时提供症状控制。这些效果在前列腺体积较大（>25 毫升）的男性中最为明显，他们处于疾病进展的最大风险中。本文综述了用于治疗 BPH 的非那雄胺的文献，并提供了其疗效、安全性和耐受性、联合治疗适用性以及对前列腺癌风险影响的证据。
