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目的联合应用缬沙坦、非那雄胺治疗高血压合并良性前列腺增生(BPH)患者,观察降压及BPH临床症状改善效果。方法采用随机平行对照的临床实验方法,入选2008-09-2010-12河南大学淮河医院门诊或住院的高血压合并BPH患者372例,分成3组:A组(口服缬沙坦80mg/d,n=138)、B组(口服缬纱坦80mg/d+非那雄胺组5mg/d,n=128)和C组(口服多沙唑嗪4mg/d+非那雄胺组5mg/d,n=106)。进行为期12月的观察,每3月随访1次。观察患者的血压水平、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、前列腺总体积以及残余尿量,评价各组患者的临床治疗情况。结果治疗6月后,3组患者前列腺总体积均较治疗前缩小(P<0.05)。C组前列腺体积缩小幅度大于A、B两组[治疗前后差值为(11.7±6.2)比(8.2±2.1)、(7.7±4.6)mL,均P<0.01]。治疗12月后,3组患者的IPSS和残余尿量均较治疗前减少,Qmax均较治疗前增加。B、C两组IPSS、Qmax及残余尿量的改善幅度大于A组[分别为IPSS:(6.8±2.6)、(7.9±2.3)比(2.6±2.2);Qmax:(3.2±1.4)、(5.3±1.2)比(1.5±1.1)mL/s;残余尿量:(15.3±21.4)、(16.8±5.9)比(8.1±9.2)mL;均P<0.01]。总的不良反应发生率为3.2%,其中A组2例(1.4%),B组4例(3.1%),C组6例(5.7%)。结论缬沙坦联合非那雄胺可改善高血压合并BPH患者的IPSS、Qmax和残余尿量水平。
Objective To investigate the effect of valsartan and finasteride in the treatment of patients with hypertension complicated with benign prostatic hyperplasia (BPH). Methods 372 patients with BPH were randomly divided into three groups: group A (oral valsartan 80mg / d, n = 138), group B (oral valsartan 80mg / d + finasteride 5mg / d, n = 128) and group C (oral doxazosin 4mg / d + finasteride 5mg / d, n = 106). For the December period of observation, follow-up every 3 months. The patients’ blood pressure, IPSS, Qmax, total prostate volume and residual urine volume were observed and the clinical treatment of each group was evaluated. Results After 6 months of treatment, the total prostatic volume in all three groups decreased compared with those before treatment (P <0.05). The volume of prostate in group C decreased more than that in group A and B (before and after treatment, the difference was (11.7 ± 6.2) vs (8.2 ± 2.1) and (7.7 ± 4.6) mL, respectively, P <0.01]. After 12 months of treatment, the IPSS and residual urine volume of the three groups decreased compared with that before treatment, and Qmax increased compared with that before treatment. The improvement rates of IPSS, Qmax and residual urine volume in groups B and C were greater than those in group A [IPSS: (6.8 ± 2.6), (7.9 ± 2.3) vs (2.6 ± 2.2), Qmax: (3.2 ± 1.4, 5.3 ± 1.2). The residual urine volume was (15.3 ± 21.4) and (16.8 ± 5.9) vs (8.1 ± 9.2) mL respectively; all P <0.01]. The overall incidence of adverse events was 3.2%, with 2 cases in group A (1.4%), 4 cases in group B (3.1%) and 6 cases (5.7%) in group C. Conclusion Valsartan combined with finasteride can improve the IPSS, Qmax and residual urine volume in hypertensive patients with BPH.