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氟喹诺酮类药物与联合疗法治疗ⅢA型慢性前列腺炎的疗效比较。

Comparison of results after fluoroquinolones and combination therapies in type IIIA chronic prostatitis.

作者信息

Altintas R, Oguz F, Beytur A, Ediz C, Gunes A, Ozer A

机构信息

Department of Urology, Medical Faculty, Inonu University, Malatya, Turquía.

出版信息

Actas Urol Esp. 2013 Nov-Dec;37(10):619-24. doi: 10.1016/j.acuro.2012.11.018. Epub 2013 Jun 13.

Abstract

PURPOSE

We investigated retrospectively the clinical outcomes of the patients with type iii inflammatory chronic prostatitis, who were treated with fluoroquinolones with and without an α-blocker between 2009-2011.

MATERIAL AND METHODS

Diagnosis was established with medical history (symptoms presented longer than 3 months within previous 6 months), physical examination, Meares-Stamey test and the questionnaire of the NIH-CPSI. The responses to the treatment were assessed with uroflowmetry test and the questionnaire of NIH-CPSI at initial and after 4 weeks of the treatment. The patients with incomplete data and treatment and who treated with α-blockers and/or antibiotics in the period 4 weeks prior to the therapy started in our clinic and had any surgery of lower urinary tract previously were excluded. The patients were classified under 6 groups; group1=ciprofloxacin, group2=ofloxacin, group3=levofloxacin, group4=ciprofloxacin+tamsulosin, group5=ofloxacin+tamsulosin, group 6=levofloxacin+tamsulosin. Wilcoxon Signed Ranks and Kruskal Wallis test were used for comparison of results. Mann Whitney U test with Bonferroni correction made was used as posthoc (P<.05).

RESULTS

The median scores of NIH-CPSI decreased significantly in all groups (P<.05). Levofloxacin reduced the median total scores of NIH-CPSI more than ciprofloxacin and ofloxacin monotherapies. The combination therapies were better than antibiotic therapies alone and best result was obtained in levofloxacin+tamsulosin combination.

CONCLUSION

Tamsulosin+fluoroquinolone (especially tamsulosin+levofloxacin) combinations yielded better results in both NIH-CPSI scores and peak flow rates.

摘要

目的

我们回顾性研究了2009年至2011年间接受氟喹诺酮类药物单独或联合α受体阻滞剂治疗的III型炎性慢性前列腺炎患者的临床结局。

材料与方法

通过病史(过去6个月内症状出现超过3个月)、体格检查、Meares-Stamey试验和美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)问卷进行诊断。在治疗初始及治疗4周后,通过尿流率测定试验和NIH-CPSI问卷评估治疗反应。排除数据不完整以及在我们诊所开始治疗前4周内接受过α受体阻滞剂和/或抗生素治疗且既往有任何下尿路手术史的患者。患者分为6组;第1组=环丙沙星,第2组=氧氟沙星,第3组=左氧氟沙星,第4组=环丙沙星+坦索罗辛,第5组=氧氟沙星+坦索罗辛,第6组=左氧氟沙星+坦索罗辛。采用Wilcoxon符号秩和检验与Kruskal Wallis检验比较结果。使用经Bonferroni校正的Mann Whitney U检验作为事后检验(P<0.05)。

结果

所有组的NIH-CPSI中位数评分均显著降低(P<0.05)。左氧氟沙星比环丙沙星和氧氟沙星单药治疗更能降低NIH-CPSI总中位数评分。联合治疗优于单独的抗生素治疗,左氧氟沙星+坦索罗辛联合治疗效果最佳。

结论

坦索罗辛+氟喹诺酮类药物(尤其是坦索罗辛+左氧氟沙星)联合治疗在NIH-CPSI评分和峰值流速方面均产生了更好的效果。

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