培训课件--慢性前列腺炎规范化诊治.ppt

特拉唑嗪治疗CPPS 的长期疗效(平均38周) P=0.03 Cheah PY et al. Urology. 2004, 64: 881 α-受体阻滞剂：复发 双盲、安慰剂对照 IIIA型患者 特拉唑嗪 (5 mg/day, n = 29) or 安慰剂 (n = 22) 疗程 8周，随访12个月 Sivkov AV et al. Urologia，2005, 1: 47-53 Sivkov AV et.al. Urologiia. 2005, 1: 47-53. α-受体阻滞剂：复发 特拉唑嗪的心血管安全性 2084名患者的 HYCAT 研究 ( Hytrin Community Assessment Trial ) 评价合用抗高血压药的症状性BPH患者服用特拉唑嗪的安全性 Urology. 1999; 54: 81-85 小结 核心：慢性前列腺炎是临床综合征 诊断：症状性诊断、排除性诊断 治疗：以改善症状、提高生活质量为目标的综合治疗 小结 ?受体阻滞剂是II/III型前列腺炎的基本药物 疗程应至少12周 特拉唑嗪安全有效 剂量可达5mg/日 * 在14周，特拉唑嗪治疗组NIH-CPSI总分下降57％（从基线25.1±7.1降到10.8±9.0 ）而安慰剂组下降37％ （从基线27.2±7.7降到17.0±12.1）P0.001。在14周特拉唑嗪治疗组NIH-CPSI总分降低57％是对照组的1.5倍（P=0.01）NIH-CPSI疼痛评分尿路评分及生活质量评分与对照组相比均有显著差异（P0.05） 特拉唑嗪治疗组I-PSS总分下降62％（从基线12.1±9.8降到4.6±6.0）而安慰剂组下降35％ （从基线14.1±2.3降到9.1±3.9）,P=0.03。 在最大尿流率和残余尿方面两组无显著差别。 * double-blind placebo-controlled trial, 51 patients, category IIla 2-week induction course of placebo followed by teraosin treatment (5 mg/day, n = 29) or placebo (n = 22) for 8 weeks. followed up for 12 months. Pretreatment differences between the groups by NIH-CPSI system, symptoms frequency scale, leukocyte count of the prostate and uroflowmetry were insignificant. Teraosin and placebo patients showed a noticeable improvement (39.7 and 9.9% by symptoms frequency scale, respectively; by 36.4 and 6.6% by the linear scale, respectively). The drug reduced pain and dysuria, improved quality of life considerably (by 36.2%). Maximal urine flow accelerated by 22.96 and 10.01% in teraosin and placebo groups, respectively. Leukocyte count fell two-fold in the study group and lowered insignificantly in the placebo group. The recurrence-free interval was 25 and 9 weeks, respectively. Thus, teraosin monotherapy improves quality of life in CAP/CPPS patients, significantly relieves symptoms and prolongs recurrence-free interval vs placebo. * * 慢性前列腺炎规范化诊治:α受体阻滞剂 北京大学泌尿外科研究所 北京大学第一医院泌尿外科 张 凯 慢性前列腺炎指NIH分类的III型，即慢性骨盆疼痛综合征（CPPS） 慢性前列腺炎的临床进展性不明确，不足以威胁患者的生命和重要器官功能 慢性前列腺炎是泌尿外科门诊最常见的疾病 慢性前列腺炎患者因误导而存在诸多误区，并由此带来身心损害