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预测前列腺动脉栓塞术(PAE)后良好症状转归的因素。

Factors Predicting a Good Symptomatic Outcome After Prostate Artery Embolisation (PAE).

作者信息

Maclean D, Harris M, Drake T, Maher B, Modi S, Dyer J, Somani B, Hacking N, Bryant T

机构信息

Department of Radiology, University Hospital Southampton, Southampton, UK.

Department of Urology, University Hospital Southampton, Southampton, UK.

出版信息

Cardiovasc Intervent Radiol. 2018 Aug;41(8):1152-1159. doi: 10.1007/s00270-018-1912-5. Epub 2018 Feb 26.

Abstract

INTRODUCTION

As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE.

MATERIALS OR METHODS

Prospective follow-up of 86 PAE patients at a single institution between June 2012 and January 2016 was conducted (mean age 64.9 years, range 54-80 years). Multiple linear regression analysis was performed to assess strength of association between clinical improvement (change in IPSS) and other variables, of any statistical correlation, through Pearson's bivariate analysis.

RESULTS

No major procedural complications were identified and clinical success was achieved in 72.1% (n = 62) at 12 months. Initial prostate size and percentage reduction were found to have a significant association with clinical improvement. Multiple linear regression analysis (r = 0.48) demonstrated that percentage volume reduction at 3 months (r = 0.68, p < 0.001) had the strongest correlation with good symptomatic improvement at 12 months after adjusting for confounding factors.

CONCLUSION

Both the initial prostate size and percentage volume reduction at 3 months predict good symptomatic outcome at 12 months. These findings therefore aid patient selection and counselling to achieve optimal outcomes for men undergoing prostate artery embolisation.

摘要

引言

随着前列腺动脉栓塞术(PAE)成为良性前列腺梗阻的既定治疗方法,预测良好症状改善结果的因素仍不明确。栓塞前前列腺大小作为预测指标存在争议,少数论文得出了相互矛盾的结论。我们旨在研究在我们的患者队列中前列腺大小与临床获益之间是否存在关联,此外还评估体积缩小百分比作为PAE后症状改善结果的预测指标。

材料与方法

对2012年6月至2016年1月在单一机构的86例PAE患者进行前瞻性随访(平均年龄64.9岁,范围54 - 80岁)。通过Pearson双变量分析进行多元线性回归分析,以评估临床改善(国际前列腺症状评分[IPSS]变化)与其他具有统计学相关性的变量之间的关联强度。

结果

未发现重大手术并发症,12个月时72.1%(n = 62)的患者取得临床成功。发现初始前列腺大小和缩小百分比与临床改善有显著关联。多元线性回归分析(r = 0.48)表明,在调整混杂因素后,3个月时的体积缩小百分比(r = 0.68,p < 0.001)与12个月时良好的症状改善相关性最强。

结论

初始前列腺大小和3个月时的体积缩小百分比均可预测12个月时良好的症状改善结果。因此,这些发现有助于患者选择和咨询,以使接受前列腺动脉栓塞术的男性获得最佳结果。

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