摘要
目的 探讨 2 型糖尿病(T2DM)病程对良性前列腺增生(BPH)患者临床进展的影响.方法 选取 2019 年 10 月至 2022 年 10 月于华中科技大学同济医学院附属同济医院就诊的 61 名BPH 合并T2DM患者的临床资料,根据T2DM病程将患者分为T2DM病程≤5 年组(短病程组)和病程>5 年组(长病程组);根据 T2DM的初始发病年龄分为≤60 岁(中年发病组)和>60 岁组(老年发病组),探讨各亚组间国际前列腺症状评分(IPSS)、前列腺体积(PV)、最大尿流率(Qmax)、初始尿意容量(FDV)、强烈尿感容量(SDV)、最大尿流率时逼尿肌压力(Pdet Qmax)、残余尿量(PVR)和患者膀胱功能的影响.结果 短病程组和长病程组在 IPSS[(23.0±3.3)分 vs(25.1±2.5)分]、FDV[(182.0±68.7)mlvs(225.6±45.3)ml]、SDV[(320.9±78.2)ml vs(387.2±69.6)ml]和PVR[(98.3±64.3)ml vs(176.3±123.0)ml]上差异有统计学意义(P<0.05),而在年龄、PV、Qmax、Pdet Qmax 上差异无统计学意义(P>0.05).长病程组逼尿肌收缩无力发生率高于短病程组(P =0.017),膀胱感觉减退与膀胱稳定性下降的发生率差异无统计学意义.通过进一步对 T2DM发病年龄分组的分析发现,T2DM中年发病组年龄小于老年发病组[(63.2±5.9)岁 vs(72.3±6.6)岁]、IPSS大于老年发病组[(25.3±2.4)分 vs(23.4±3.2)分],差异有统计学意义(P<0.05).中年发病和老年发病组在PV、Qmax、FDV、SDV、Pdet Qmax、PVR、膀胱功能障碍发生率上的均差异无统计学意义.结论 T2DM病程延长存在加重 BPH 病情的风险,且 T2DM中年发病人群风险更大,此类患者需要控制好血糖正常与平稳,重视BPH 患者的长期随访,必要时行积极的干预措施.
Abstract
Objective To investigate the effect of the course and age of onset of type 2 diabetes mellitus(T2DM)on the clinical progression of benign prostatic hyperplasia(BPH).Methods Clinical data of 61 BPH patients with T2DM treated in Tongji Hospital from October 2019 to Octo-ber 2022 were selected,and the patients were divided into short course group(≤5 years)and long course group(>5 years)according to the course of T2DM.According to the initial onset age of T2DM,T2DM was divided into middle-aged onset group(≤60 years old)and elderly onset group(>60 years old).The differences of International prostate symptom score(IPSS),prostate volume(PV),maximum flow rate(Qmax),first desire volume(FDV),strong desire volume(SDV)and maximum flow rate of the detrusor pressure(Pdet Qmax),post-void residual volume(PVR)and blad-der function were in investigated ineach subgroup.Results The differences were statistically sig-nificant(P<0.05)between the short and long course of disease groups in thr levels of IPSS(23.0±3.3 and 25.1±2.5 points),FDV(182.0±68.7 ml and 225.6±45.3 ml),SDV(320.9±78.2 ml vs.387.2±69.6 ml,P=0.002),PVR(98.3±64.3 ml vs.176.3±123.0 ml),but there was no statistically significant difference in age,PV,Qmax,Pdet Qmax(P>0.05).The incidence of detrusor muscle weakness in the long course group was higher than that in the short course group(P =0.017).There was no significant difference in the incidence of bladder hypoesthesia or bladder stability.Through further anal-ysis of the age groups of T2DM onset,it was found that the age of the middle-aged onset group was younger than that of the elderly onset group(63.2±5.9 years vs.72.3±6.6 years,P<0.001),and the IPSS was higher than that of the elderly onset group(25.3±2.4 points vs.23.4±3.2 points,P=0.013).There were no significant differences PV,Qmax,FDV,SDV,Pdet Qmax,PVR,or incidence of bladder dysfunction between middle-aged and elderly patients.Conclusions Prolonged disease course of T2DM is associated with the risk of aggravating BPH,especially in middle-aged people.Such patients need contrdling blood glucose normally and smoothly,paying attention to long-term follow-up of BPH,and the risk of T2DM especially and taking more active intervention measures when necessary.
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