Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
J Urol. 2011 Mar;185(3):1003-9. doi: 10.1016/j.juro.2010.10.085. Epub 2011 Jan 19.
We evaluated symptom specific goal achievement, and the correlations between goal achievement and traditional outcome measures after pharmacological therapy in patients with benign prostatic obstruction.
Men 50 years old or older with lower urinary tract symptoms secondary to benign prostatic obstruction and International Prostate Symptom Score 8 or greater were enrolled and treated with 10 mg alfuzosin XL for 12 months. Before treatment, face-to-face interviews were conducted to identify the single most bothersome symptoms and to set treatment goals for the symptoms in individual patients. After treatment, patients described perceptions of goal achievement using a 5-point Likert scale. Changes in International Prostate Symptom Score/quality of life score, International Continence Society male short form questionnaire, 3-day voiding diary and uroflowmetry parameters were analyzed to evaluate the correlations between goal achievement and traditional outcome measures.
Of 108 most bothersome symptoms slow stream (26.9%) was the most frequently reported followed by increased daytime frequency (21.3%) and nocturia (19.4%). After treatment the median score of goal achievement was 3 points with no significant difference among most bothersome symptoms. Changes in quality of life score (correlation coefficient -0.247, p=0.020) and maximal flow rate (correlation coefficient 0.254, p=0.021) were correlated with goal achievement. For men with most bothersome symptoms of storage, changes in the number of micturition and urgency episodes per 24 hours were correlated with goal achievement. For men with most bothersome symptoms of voiding the International Prostate Symptom Score voiding score was correlated with goal achievement.
Assessing goal achievement for most bothersome symptoms can be a useful outcome measure in patients with benign prostatic obstruction with heterogeneous symptoms or goals reflecting change in quality of life.
我们评估了良性前列腺增生患者药物治疗后症状特异性目标的实现情况，以及目标实现与传统结局指标之间的相关性。
纳入年龄 50 岁及以上，因良性前列腺梗阻导致下尿路症状且国际前列腺症状评分（International Prostate Symptom Score，IPSS）≥8 分的患者，给予 10mg 阿夫唑嗪 XL 治疗 12 个月。治疗前，对患者进行面对面访谈，以确定每位患者最困扰的单一症状，并为其症状设定治疗目标。治疗后，患者使用 5 分 Likert 量表描述对目标实现的感知。分析 IPSS/生活质量评分、国际尿控协会男性简短问卷、3 天排尿日记和尿流率参数的变化，以评估目标实现与传统结局指标之间的相关性。
108 个最困扰的症状中，排尿困难（26.9%）是最常见的，其次是白天排尿次数增加（21.3%）和夜尿（19.4%）。治疗后，目标实现的中位数评分为 3 分，最困扰症状之间无显著差异。生活质量评分（相关系数-0.247，p=0.020）和最大尿流率（相关系数 0.254，p=0.021）的变化与目标实现相关。对于最困扰症状为储存症状的男性，24 小时内排尿和尿急次数的变化与目标实现相关。对于最困扰症状为排尿症状的男性，IPSS 排尿评分与目标实现相关。
评估最困扰症状的目标实现情况，对于症状多样或目标反映生活质量变化的良性前列腺增生患者，可作为一种有用的结局指标。
