与BPH相关的LUTS的药物治疗:药物模式,持久性和治疗失败之间的关联
Takeshi Soda1, Tomohide Yamauchi2, Hikari Otsuka2
1Department of Urology, Medical Research Institute Kitano Hospital, 2-4-20 Ogimachi, Kita-ku, Osaka, Osaka, 530-8480, Japan. ts11885@gmail.com.
World journal of urology
|April 23, 2025
概括
非标准药物,如5α-减少酶抑制剂 (5ARIs) 和固酶-5抑制剂 (PDE5Is),可以改善良性前列腺增生症 (BPH) 的治疗持续性. 5ARIs还显著降低了BPH患者急性尿路保留 (AUR) 风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
- 现实世界的证据.
背景情况:
- 良性前列腺增生症 (BPH) 是老年男性常见的疾病.
- 药物治疗是BPH的主要治疗方式.
- 了解现实世界的治疗模式及其影响对于优化患者的治疗结果至关重要.
研究的目的:
- 评估BPH男性的现实世界医疗治疗概况.
- 评估处方模式对治疗持续性和失败的影响.
- 分析影响急性尿 (AUR) 和手术进展的因素.
主要方法:
- 对779名开始药物治疗的患者 (α-阻断剂,5-α-减少酶抑制剂,PDE5抑制剂) 的回顾性图表审查.
- 用于评估治疗持续性,AUR发展和手术进展的多变量Cox比例危险模型.
- 应用多重归算来解决缺失的基线值.
主要成果:
- 阿尔法阻断剂单一治疗是最常见的初始治疗方法 (76%).
- 使用5α-减少酶抑制剂 (5ARIs) 和化酶-5抑制剂 (PDE5Is) 与更大的治疗持久性有关.
- 使用5ARI显著降低了AUR风险,而前列腺扩大增加了AUR的可能性. 更大的前列腺体积,空白后残留体积> 100毫升,以及最初的AUR预测了手术进展.
结论:
- 尽管使用有限,5ARIs,PDE5Is,抗肌糖药和β-3激动剂与BPH治疗持续时间较长有关.
- 5ARIs显示急性尿 (AUR) 的风险显著降低.
- 现实世界的数据强调了非标准药物治疗在改善BPH管理方面的好处.
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