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良性前列腺增生所致膀胱出口梗阻与肺血栓栓塞之间存在关联吗?

Is there a relationship between bladder outlet obstruction due to benign prostatic hyperplasia and pulmonary thromboembolism?

作者信息

Rosenfeld Hannah E, Byard Roger W

机构信息

The University of Adelaide Medical School, Frome Road, Adelaide, SA 5005, Australia.

出版信息

J Forensic Sci. 2012 May;57(3):663-4. doi: 10.1111/j.1556-4029.2011.02042.x. Epub 2012 Jan 23.

Abstract

Benign prostatic hyperplasia with chronic bladder outlet obstruction has been associated with deep venous thrombosis (DVT) and fatal pulmonary thromboembolism (PTE). To evaluate this further, 60 autopsy cases of men with PTE were compared with 60 age-matched controls. The criteria for outlet obstruction were macroscopic prostatic enlargement with bladder trabeculation and benign prostatic hyperplasia on microscopy. Ten of the 60 men (16.7%) with fatal PTE had evidence of bladder outlet obstruction (age 57-78 years; mean 71.4 years). Of the 60 controls, 12 had evidence of bladder outlet obstruction (20%) (age 67-86 years; mean 75.5 years). No significant relationship could be demonstrated between bladder outlet obstruction and fatal PTE cases (p = 0.8). Given reports of this association, however, it is possible that bladder distension with venous compression may act as a risk modifier in certain individuals in association with other significant comorbidities, but this risk appears low.

摘要

良性前列腺增生伴慢性膀胱出口梗阻与深静脉血栓形成(DVT)及致命性肺血栓栓塞症(PTE)相关。为进一步评估这一关联,将60例死于PTE的男性尸检病例与60例年龄匹配的对照进行比较。出口梗阻的标准为肉眼可见前列腺增大伴膀胱小梁形成以及显微镜下诊断为良性前列腺增生。60例死于致命性PTE的男性中,有10例(16.7%)存在膀胱出口梗阻证据(年龄57 - 78岁;平均71.4岁)。60例对照中,有12例(20%)存在膀胱出口梗阻证据(年龄67 - 86岁;平均75.5岁)。膀胱出口梗阻与致命性PTE病例之间未显示出显著相关性(p = 0.8)。然而,鉴于有关于这种关联的报道,膀胱扩张伴静脉受压有可能在某些个体中与其他严重合并症共同作用成为一种风险修正因素,但这种风险似乎较低。

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