Girman C J, Jacobsen S J, Guess H A, Oesterling J E, Chute C G, Panser L A, Lieber M M
Department of Epidemiology, Merck Research Laboratories, West Point, Pennsylvania, USA.
J Urol. 1995 May;153(5):1510-5. doi: 10.1016/s0022-5347(01)67448-2.
We describe relationships among symptoms, prostate volume and peak urinary flow rate in an age stratified, community based random sample of white men 40 to 79 years old with no prior prostate surgery, prostate cancer or other conditions known to interfere with voiding. Symptoms were assessed with an instrument comparable to the American Urological Association symptom index. Prostate volume was estimated by transrectal ultrasonography and peak urinary flow rate was measured by a portable device. Subject age was significantly associated with symptom score but accounted for only 3% of its variation, while prostate volume and peak urinary flow rate explained only an additional 10% of the symptom variability. The odds (95% confidence interval) of moderate to severe symptoms increased with age from 1.9 (1.1 to 3.1), 2.9 (1.7 to 5.0) and 3.4 (1.8 to 6.1) for men 50 to 59, 60 to 69 and 70 to 79 years old, respectively, relative to men 40 to 49 years old. Adjusting for age, the odds of moderate to severe symptoms were 3.5 times greater for men with prostatic enlargement (more than 50 ml.) than for men with smaller prostates, while the odds were similarly increased (2.4-fold) for men not achieving a peak urinary flow rate of 10 ml. per second. Estimated odds changed little when other cutoff points were considered for peak urinary flow rate (15 ml. per second) or prostate volume (40 ml.). These results, based on randomly selected white men, suggest a somewhat stronger, albeit modest, relationship among symptoms, prostate size and urinary flow rate than previously reported in clinic based studies. The strength of these relationships is comparable to that found with other diseases.
我们描述了40至79岁未接受过前列腺手术、无前列腺癌或其他已知会干扰排尿的疾病的白人男性中，症状、前列腺体积与最大尿流率之间的关系，这些男性来自一个基于社区的年龄分层随机样本。使用与美国泌尿外科学会症状指数相当的工具评估症状。通过经直肠超声检查估计前列腺体积，并使用便携式设备测量最大尿流率。受试者年龄与症状评分显著相关，但仅占其变异的3%，而前列腺体积和最大尿流率仅额外解释了症状变异性的10%。50至59岁、60至69岁和70至79岁男性出现中度至重度症状的几率（95%置信区间）相对于40至49岁男性分别从1.9（1.1至3.1）、2.9（1.7至5.0）和3.4（1.8至6.1）随年龄增加。调整年龄后，前列腺增大（超过50毫升）的男性出现中度至重度症状的几率是前列腺较小男性的3.5倍，而最大尿流率未达到每秒10毫升的男性几率同样增加（2.4倍）。当考虑最大尿流率（每秒15毫升）或前列腺体积（40毫升）的其他截断点时，估计几率变化不大。这些基于随机选择的白人男性的结果表明，症状、前列腺大小和尿流率之间的关系比之前基于临床研究报告的关系更强，尽管程度有限。这些关系的强度与其他疾病的相当。
