Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine , Ansan , Republic of Korea.
Korea University Anam Hospital, Korea University College of Medicine , Seoul , Republic of Korea.
J Urol. 2019 Aug;202(2):362-368. doi: 10.1097/JU.0000000000000209. Epub 2019 Jul 8.
A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia.
From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis.
During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97%, 18.55%, 20.64%, 17.62% and 22.60%, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95% CI 0.960-1.121 and HR 1.008, 95% CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95% CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort.
The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.
最近的一项研究表明，坦索罗辛会增加良性前列腺增生患者患痴呆症的风险。然而，这项研究存在一些局限性。我们评估了 α-受体阻滞剂与良性前列腺增生患者痴呆症之间的关系。
我们从国家健康保险服务数据库中收集了 2011 年 1 月至 2011 年 12 月期间患有良性前列腺增生的所有韩国成年人群中 α-受体阻滞剂和痴呆症的数据，并进行了分析。这些患者随访至 2017 年 9 月。我们使用倾向评分匹配 Cox 比例风险回归模型和 Kaplan-Meier 生存分析来测试 α-受体阻滞剂对痴呆风险的影响。
在平均随访 1580 ± 674.3 天期间，符合所有纳入和排除标准的良性前列腺增生患者为 59263 例。在未调整的队列中，坦索罗辛、多沙唑嗪、特拉唑嗪、阿夫唑嗪和未用药队列的痴呆发生率分别为 17.97%、18.55%、20.64%、17.62%和 22.60%。在倾向评分匹配后，坦索罗辛队列与多沙唑嗪和阿夫唑嗪队列的痴呆风险无显著差异（HR 1.038，95%CI 0.960-1.121 和 HR 1.008，95%CI 0.925-1.098）。与坦索罗辛队列相比，特拉唑嗪队列痴呆风险更高（HR 1.112，95%CI 1.052-1.196）。然而，与未用药队列相比，特拉唑嗪队列的痴呆风险显著降低。
研究结果表明，根据使用时间或类型，良性前列腺增生药物与痴呆风险无关。
