摘要
目的观察老年良性前列腺增生（BPH）患者对药物治疗的依从性及其原因。方法对我院老年泌尿内科就诊的103例年龄66～93岁，平均（78．2±5．9）岁接受5a还原酶抑制剂（非那雄胺）和（或）a受体阻滞剂（坦索罗辛、多沙唑嗪或特拉唑嗪）治疗的BPH患者随访观察6个月。回顾性分析患者治疗前临床指标、治疗过程的用药情况、用药时间、停药和换药情况及不良反应等资料。结果共随访103例老年BPH患者，使用a受体阻滞剂者30例（29．1％），使用非那雄胺者25例（24．3％），联合治疗者48例（46．6％）。随访患者在药物治疗6个月后药物持有比率为0．89土0．23，依从性好的患者82例（79．6％），停药6例（5．8％），换药7例（6．8％），治疗有效率为73．8％（76例），不良反应发生率12．6％（13例），急性尿潴留发生率15．5％（16例），BPH相关手术发生率为4．9％（5例）。非那雄胺治疗患者的药物持有率和依从性好的患者比例均高于a受体阻滞剂治疗和联合治疗患者，但差异无统计学意义（均P〉0．05）。依从性好患者治疗有效率高于依从性差者，而不良反应发生率和急性尿潴留发生率均低于依从性差者，差异有统计学意义。结论老年BPH患者药物治疗依从性好，可能与药物治疗效果好、不良反应少有关。
Objective To investigate the compliance with medical therapy in elderly patients with benign prostatic hyperplasia （BPH）. Methods The BPH patients aged 66 to 93 treated with 5-reductase inhibitor （finasteride） and/or c% blockers （tamsulosin, doxazosin or terazosin） were followed up for 6 months. The retrospective data, including international prostatic symptom score （IPSS）, quality of life （QOL）, maximum flow rate （Qmax）, prostate volume （PV）, the information of medical types, total number of days of medication supplied, discontinuation and switching of therapy, and adverse effects were collected and analyzed. Results In all 103 subjects, 30 patients （29.1%） received a-blockers, 25 patients （24.3%） received finasteride, and 48 patients （46.6%） received combination therapy. After a follow-up of 6 months, the medication possession ratio （MPR） was 0.89±0.23 with a good-compliance rate （MPR〈0.8）, discontinuation rate and switching rate were 79.6% （82 cases）, 5.8% （6 cases） and 6.8o/oo （7 cases）, respectively, while the efficacy rate, the adverse reaction rate, incidence of acute urinary retention （AUR） and incidence of BPH related operations were 73.8% （76 cases）, 12.6% （13 cases）, 15.5% （16 cases）and 4.9o//oo （5 cases）, separately. The MPR （0.90 4- 0.24） and good-compliance rate （84.0%） in patients treated with finasteride were both greater than those with a blockers （0.87 _--＋- 0.25, 76.7%） and combination therapy （0.89±0.22, 79.2%）, but with no significant difference. Compared with patients with bad- compliance, the efficacy ratio of medical therapy was significant higher in patients with good- compliance （81.7% vs. 42.9%）, while the incidence of adverse effects and AUR were significant fewer （7.3 % vs. 33.3 % and 9.8 vs. 38. 1 %） . Conclusions Elderly patients received either monotherapy or combination therapy with finasteride and a-blockers have good-compliance, whichmight be associated with the good eff
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第2期224-227,共4页
Chinese Journal of Geriatrics
关键词
前列腺增生
药物治疗依从性
Prostatic hyperplasia
Medication adherence
