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疾病进展风险患者对良性前列腺增生管理的行为和态度:“前列腺与治疗期望流行病学研究(PETER)研究组”的前瞻性研究

Patient's behavior and attitudes toward the management of benign prostatic hyperplasia among patients with the risk of disease progression: prospective study by "Prostate and Expectations of Treatment Epidemiology Research (PETER) study group".

作者信息

Weibl Peter, Klatte Tobias, Laurinc Peter, Tomaškin Roman, Shariat Shahrokh F, Helbich Miroslav, Fackovcova Danica, Bujdák Peter

机构信息

Department of Urology, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria,

出版信息

Wien Klin Wochenschr. 2015 May;127(9-10):363-8. doi: 10.1007/s00508-014-0668-4. Epub 2014 Dec 2.

Abstract

BACKGROUND

The aim of the study was to evaluate patients attitudes with benign prostatic hyperplasia at the risk of progression during a 12-month period of observation.

MATERIALS AND METHODS

A total of 426 patients from 45 outpatients centers were included and prospectively followed. Inclusion criteria were: age > 50 years, International Prostate Symptom Score (IPSS) > 8, prostate volume > 30 cm(3) (transabdominal ultrasound) and PSA > 1.5 to < 10 ng/ml.

RESULTS

In all, 28.6% patients were naive, 62.9% used monotherapy (alpha-blocker), and 8.5% combined treatment (alpha-blocker/5alpha-reductase inhibitor/dutasteride). The most bothersome symptoms were the weak urine stream (60.8%) and nocturia (59.2%). Patients expectations from the treatment were stabilization of the disease and reducing the risk of surgery rather than rapid resolution of symptoms. Despite the presence of symptoms, 2.3% patients claimed that benign prostatic hyperplasia/lower urinary tract symptoms had no impact on their quality of life (QoL), in 48.1 % only little impact on QoL, and 47.9% patients percepted their symptoms as severe. Out of 71.4% patients treated previously, 26.5% patients were indecisive about the satisfaction of present treatment. Visual analog score was percepted more optimistically rather than the IPSS. Pearson's correlation r = 0.68 at the beginning and r = 0.83 at the end of the study.

CONCLUSIONS

Prostate and Expectations of Treatment Epidemiology Research study highlights and reflects on patients behavior and self-perception, patients self-perception of the disease and therapeutic priorities during the 1 year of observation.

摘要

背景

本研究旨在评估良性前列腺增生患者在12个月观察期内疾病进展风险的态度。

材料与方法

纳入45个门诊中心的426例患者并进行前瞻性随访。纳入标准为:年龄>50岁,国际前列腺症状评分(IPSS)>8,前列腺体积>30 cm³(经腹超声),前列腺特异性抗原(PSA)>1.5至<10 ng/ml。

结果

总体而言,28.6%的患者未接受过治疗,62.9%使用单一疗法(α受体阻滞剂),8.5%采用联合治疗(α受体阻滞剂/5α还原酶抑制剂/度他雄胺)。最困扰的症状是尿流无力(60.8%)和夜尿症(59.2%)。患者对治疗的期望是疾病稳定和降低手术风险,而非症状快速缓解。尽管存在症状,但2.3%的患者称良性前列腺增生/下尿路症状对其生活质量(QoL)无影响,48.1%的患者认为对QoL影响很小,47.9%的患者认为其症状严重。在71.4%之前接受过治疗的患者中,26.5%的患者对当前治疗的满意度犹豫不决。视觉模拟评分比IPSS更乐观。研究开始时皮尔逊相关系数r = 0.68,研究结束时r = 0.83。

结论

前列腺与治疗期望流行病学研究突出并反映了患者在1年观察期内的行为和自我认知、患者对疾病的自我认知以及治疗重点。

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