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中華民國泌尿科醫學會雜誌

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篇名 Efficacy of Combined Finasteride and α1-blocker Treatment for Benign Prostatic Hyperplasia after Initial Unsatisfactory Response to α1-blocker
卷期 11:4
並列篇名 α1腎上腺素阻斷劑治療攝護腺肥大效果不滿意時合併finasteride的臨床效益
作者 歐建慧唐一清林信男蔡宗欣楊文宏張建成鄭鴻琳林永明
頁次 167-171
關鍵字 攝護腺肥大α1腎上腺素阻斷劑finaster ideBenign prostatic hyperplasiaα1-blockerfinasterideTSCI
出刊日期 200012

中文摘要

目的:本研究的目的在評估攝護腺肥大病患接受合併α1腎上腺素阻斷劑及finasteride治療的臨床效益。材料及方法:從1995至1998年,總共69位病患,在平均服用α1腎上腺素阻斷劑6.5個月後,併用finasteride治療攝護腺肥大。我們評估這些病患在接受合併治療後,攝護腺體積,攝護腺特異抗原,最大尿流速,國際攝護腺症狀評分及生活品質改善情形,攝護腺體積及攝護腺特異抗原有明顯縮小及下降情形,攝護腺體積在合併治療第一年及第一年以後,分別平均縮小20%及17%,攝護腺特異抗原在合併治療第一年及第一年以後,分別平均下降47%及57%,病患的國際攝護腺症狀評分及生活品質在接受合併治療後,也有改善情形。但就最大尿流速而言,只有攝護腺體積大於35cm3或攝護腺特異抗原大於4ng/ml的病患,在接受合併治療第一年時,有明顯增加的情形(分別平均增加1.8及1.1ml/sec)。結論:合併α1腎上腺素阻斷劑及finasteride治療攝護腺肥大,對於攝護腺體積大於35cm3或攝護腺特異抗原大於4ng/ml的病患,可以預期得到較多的臨床效益。

英文摘要

OBJECTIVE: The purpose of our study was to assess the efficacy of a combination of finasteride and alphal-adrenergic antagonist(α1-blocker)for treatment of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Charts of 69 patients with symptoms of BPH treated at our department from January 1995 to December 1998 with α1-blocker first then in combination with finasteride (ProscarR 5 mg/day) owing to the unsatisfactory subjective response to the initial α1-blocker were retrospectively reviewed. Data were collected with regards to prostate volume, uroflow rate, and PSA levels before and after finasteride. Changes in prostate volume, PSA level, and maximum uroflow rate were recorded and analyzed for each patient RESULTS: There was a statistically significant decrease in prostate volume and prostate specific antigen level after combination therapy. A mean decrease in prostate volume of 20%±14% was achieved in the first year and 17%±17% in the second year of combination therapy. Mean reductions of 47%± 48% and 57%±34% in serum PSA levels were achieved in the first and second years, respectively. For maximal uroflow rate (Qmax), a significant increase from combination therapy was observed only in patients with baseline PSA values greater than 4 ng/ml and prostate volumes greater than 35cm3 in the first year of treatment (mean 1.1±3.0 and 1.8±3.3ml/s increase, respectively). However, all patients showed improvement in symptoms and quality of life. CONCLUSIONS: Based on our observations, patients with higher baseline PSA levels and larger prostate volumes benefited the most from a combination of finasteride and α1-blocker for treatment of BPH.