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5α-还原酶抑制剂在前列腺动脉栓塞术治疗良性前列腺梗阻时的应用影响

Impact of 5-Alpha-Reductase Inhibitors Use at the Time of Prostatic Artery Embolization for Treatment of Benign Prostatic Obstruction.

作者信息

Cardarelli-Leite Leandro, de Assis Andre M, Moreira Airton M, Antunes Alberto A, Cerri Giovanni G, Srougi Miguel, Carnevale Francisco C

机构信息

Department of Radiology, University of Sao Paulo Medical School, Sao Paulo, Brazil.

Department of Radiology, University of Sao Paulo Medical School, Sao Paulo, Brazil.

出版信息

J Vasc Interv Radiol. 2019 Feb;30(2):228-232. doi: 10.1016/j.jvir.2018.11.027.

Abstract

PURPOSE

To compare the 12-month post-prostatic artery embolization (PAE) clinical outcomes of patients who were and were not taking 5-alpha-reductase inhibitors (5ARIs) at the time of PAE.

MATERIALS AND METHODS

A retrospective review was conducted of patients who underwent PAE from 2010 to 2017 due to lower urinary tract symptoms, secondary to benign prostatic hyperplasia (BPH). One hundred fifty-five patients were included and divided in 2 groups; these groups did not present statistically significant differences in their baseline characteristics-those taking 5ARIs (Y-5ARIs, n = 40) and those not taking 5ARIs (N-5ARIs, n = 115). International Prostate Symptom Score (IPSS), the sub-item Quality of Life (QoL), and the incidence of clinical failure were used as primary endpoints. Secondary endpoints included mean prostate volume reduction and mean peak flow rate (Q) improvement. Clinical failure or recurrence was defined as absence of symptomatic improvement (IPSS ≥ 8 or QoL ≥ 3) or the need for invasive BPH treatment (PAE or transurethral resection of the prostate) during the 12-month follow-up period.

RESULTS

After 12-month follow-up, IPSS, QoL, and prostatic volume were significantly lower compared to baseline in both groups, and Q showed a significant increase. No statistically significant differences were observed in outcomes between N-5ARIs and Y-5ARIs, and the clinical failure rate for both groups was approximately 20%.

CONCLUSIONS

The use of 5ARIs did not show a detrimental effect on clinical outcomes of PAE, in either subjective (IPSS, QoL, and clinical failure) or objective (prostatic volume and Q) parameters.

摘要

目的

比较前列腺动脉栓塞术(PAE)后12个月时,在PAE手术时正在服用和未服用5α-还原酶抑制剂(5ARIs)的患者的临床结局。

材料与方法

对2010年至2017年因良性前列腺增生(BPH)继发下尿路症状而接受PAE的患者进行回顾性研究。纳入155例患者并分为两组;这两组在基线特征方面无统计学显著差异,即服用5ARIs的患者(Y-5ARIs,n = 40)和未服用5ARIs的患者(N-5ARIs,n = 115)。国际前列腺症状评分(IPSS)、生活质量子项(QoL)和临床失败发生率被用作主要终点。次要终点包括平均前列腺体积缩小和平均最大尿流率(Q)改善。临床失败或复发定义为在12个月随访期内无症状改善(IPSS≥8或QoL≥3)或需要进行侵入性BPH治疗(PAE或经尿道前列腺切除术)。

结果

随访12个月后,两组的IPSS、QoL和前列腺体积均较基线显著降低,Q显著升高。N-5ARIs组和Y-5ARIs组在结局方面未观察到统计学显著差异,两组的临床失败率均约为20%。

结论

使用5ARIs对PAE的临床结局在主观(IPSS、QoL和临床失败)或客观(前列腺体积和Q)参数方面均未显示出有害影响。

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