Lepor H
Division of Urologic Surgery, Jewish Hospital of St. Louis, MO 63110.
Int J Clin Pharmacol Ther Toxicol. 1989 Apr;27(4):151-5.
Benign prostatic hyperplasia (BPH) describes a benign enlargement of the prostate gland that develops in the aging male population. Approximately 50% of 60-year-old men have histologic evidence of BPH. The clinical manifestations of BPH are related entirely to the obstruction of urinary outflow. Benign prostatic hyperplasia produces obstruction to urinary flow by static and dynamic factors. The dynamic component of infravesical obstruction presumably is mediated by the tone of the prostate smooth muscle. Pharmacologic agents that cause relaxation of the prostate may represent an effective therapeutic approach for symptomatic BPH. Organ bath contractile studies have indicated that the contractile properties of prostate adenoma are mediated by alpha1 adrenoceptors. Ten clinical trials evaluating the efficacy of alpha adrenergic blockers for the treatment of symptomatic BPH have been performed in Europe during the past 11 years. Clinical efficacy was observed in 9 of the 10 clinical trials. Randomized, placebo controlled, multicenter clinical trials are currently in progress in the United States to evaluate the efficacy of alpha blockers for the treatment of BPH. Rationale and the clinical experience of alpha adrenergic blockers for the treatment of symtomatic BPH is reviewed in this article.
良性前列腺增生（BPH）是指前列腺腺体的良性增大，发生于老年男性群体。60岁男性中约50%有BPH的组织学证据。BPH的临床表现完全与尿路流出道梗阻有关。良性前列腺增生通过静态和动态因素导致尿流梗阻。膀胱下梗阻的动态成分可能由前列腺平滑肌的张力介导。能使前列腺松弛的药物可能是治疗有症状BPH的一种有效方法。器官浴收缩研究表明，前列腺腺瘤的收缩特性由α1肾上腺素能受体介导。在过去11年中，欧洲进行了10项评估α肾上腺素能阻滞剂治疗有症状BPH疗效的临床试验。10项临床试验中有9项观察到了临床疗效。美国目前正在进行随机、安慰剂对照、多中心临床试验，以评估α阻滞剂治疗BPH的疗效。本文综述了α肾上腺素能阻滞剂治疗有症状BPH的理论依据和临床经验。
