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題 名 | Transition Zone Index of the Prostate as an Indicator of Bladder Outlet Obstruction and a Predictor of Response to Medical Treatment in Symptomatic Benign Prostatic Hyperplasia=使用前列腺過渡區指數在有症狀之良性前列腺肥大評估膀胱外阻塞及藥物治療效果 |
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作 者 | 郭漢崇; | 書刊名 | 慈濟醫學 |
卷 期 | 9:4 1997.12[民86.12] |
頁 次 | 頁249-258 |
分類號 | 415.863 |
關鍵詞 | 良性前列腺肥大; 前列腺過渡區; 過渡區指數; 藥物治療; Benign prostatic hyperplasia; Transition zone; Transitional zone index; Finasteride; Dibenyline; |
語 文 | 英文(English) |
中文摘要 | 為了釐清前列腺過渡區指數(transition zone index, TZI)在良性前列腺肥大 的角色, 我們評估了 225 位具有症狀之良性前列腺肥大病人,在其藥物治療前後的症狀及 尿流速變化。這些病人均是接受藥物治療其前列腺肥大症狀,並評估其治療效果。治療前的 症狀積分(採用 IPSS ),最大尿流速( Qmax )及全前列腺容積用來當作病人的阻塞參數 ,而以經直腸超音波測量之全前列腺容積,過渡區容積以及過渡區指數則用來當作前列腺容 積參數。我們利用多重回歸分析阻塞參數與前列腺容積參數之間的相關性。對於病人治療 6 個月後,成功與失敗群之前列腺參數亦加以比較以期求得預測藥物治療效果之參考值。 TZI 與前列腺容積及過渡區容積有很好的相關性( p=0.000 ), 且與病人年齡( p=0.017 ),症狀積分 IPSS ( p=0.02 ),Qmax ( p=0.02 )均有很好的相關性。 過渡區容積則 僅與年齡有相關性( p=0.021 ),在全部病人中平均全前列腺容積僅有 27.9 ± 15.4mL, 過渡區容積為 10.4 ± 8.5mL,而 TZI 則為 0.34 ± 0.11,顯示本研究群的病人為具有小 的前列腺但症狀嚴重者。 當我們比較在藥物治療效果良好的病人之前列腺容積參數, 可以發現較高的 TZI 與病人的 IPSS 良好改善( IPSS 減少 10 以上)有關, 尤其在病人單獨以 finasteride 治療( p=0.05 )及病人以 finasteride 加 dibenyline 同時治療( p=0.007 )兩組最為明顯。 而在使用 finasteride 的病人中,Qmax 有良好改善( Qmax 增加 1.5 mL/sec )的病人中 其 TZI 亦較高。 全前列腺容積及過渡區容積則僅有同時使用 finasteride 及 dibenyline 病人組中有較好的 IPSS 改善病人中有有意義的差別。在所有的前列腺容積參數中,TZI 是 較為可信賴的指標以評估有症狀的前列腺肥大。 一個較高的 TZI 不僅意味病人有較嚴重的 前列腺阻塞, 也可用來預測病人在使用 finasteride 或共同使用 finasteride 及 dibenyline 時有較良好的治療效果。 |
英文摘要 | The purpose of this study was to assess the correlation between the transition zone index (TZI) of the prostate and lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH), and the value of the TZI in predicting treatment outcome. Two hundreds and twenty-five men (mean ± SD age, 66.9 ± 7.7 years ) received treatment for 6 months with dibenyline (10 mg bid), finasteride (5 mg qd), or dibenyline and finasteride. Parameters of urinary flow obstruction and prostatic volume were evaluated before and at the end of treatment. The pretreatment symptom socre (IPSS), maximal flow rate (Qmax), and total prostatic volume were used as parameters of obstruction. Total prostatic volume, transition zone volume, and TZI were used as prostatic volume parameters in transrectal sonography. Correlations between obstructive and prostatic volume parameters were analyzed using multiple regression. TZI showed significant correlations with age (p=0.017), IPSS (p=0.02), Qmax (p=0.02), total prostatic volume (p=0.00), and transition zone volume (p=0.00). Transition zone volume was correlated with age (p=0.019) and IPSS (p=0.02), whereas total prostatic volume correlated only with age (p=0.021). The mean total prostatic volume was 27.9 ± 15.4 mL, the transition zone volume was 10.4 ± 8.5mL, and the TZI was 0.34 ± 0.11, indicating patients had, on average, small prostates despite their severe symptoms. High TZI values were associated with improvement of IPSS in patients treated with finasteride alone (p<0.05), and in those treated with combined drugs (p=0.007). A higher TZI was also noted in patients with increased Qmax values who were treated with finasteride alone (p<0.05). Total prostatic volume and transition zone volume were significantly higher only in patients with IPSS improvement who were treated with combined drugs. TZI was the most reliable parameter among all prostatic volume parameters for assessing symptomatic BPH. A higher TZI not only indicated a severe bladder outlet obstruction caused by BPH, but also predicted a favorable response to finasteride and combination treatment. |
本系統中英文摘要資訊取自各篇刊載內容。