目的 调查良性前列腺增生（BPH）患者对前列腺手术的接受意愿,并分析其影响因素。方法 采用问卷调查法,于2021年3月—2022年10月选取中山大学附属第一院惠亚医院收治的133例BPH患者为研究对象。由调查者床边发放问卷,并当场收回。结果 调查共发放问卷133份,回收有效问卷130份,有效率为97.74%。单因素分析结果显示,经济负担、医保报销、BPH程度、住院陪护、了解BPH对自身的危害等因素与患者接受手术意愿相关（P<0.05）。Logistic多因素回归分析显示,患者的经济负担、医保报销及已存在BPH并发症是影响患者接受手术意愿的因素（P<0.05）。结论 本区域BPH患者由于经济、医保及已存在BPH并发症的问题,直接影响了接受前列腺手术的意愿,不仅影响患者的生理健康,也影响生活质量及家庭和睦关系,应加大疾病认知宣传力度,组建患者互助团体,促进居民对BPH疾病及手术的了解,提高该类患者的生活质量。

Objective To investigate the willingness of patients with benign prostatic hyperplasia（BPH）to accept prostate surgery and analyze its influencing factors．Methods A questionnaire survey method was used to select 133 patients with BPH admitted to a hospital from March 2021 to October 2022．The questionnaires were distributed and collects by the investigator at the bedside．Results A total of 133 questionnaires were distributed during the survey and 130 valid questionnaires were collected,with an effective rate of 97.74%．The results of single factor analysis showed that factors such as financial burden,medical insurance reimbursement,degree of BPH,hospitalization accompaniment,and understanding of the harm of prostate hyperplasia were significantly related to patients’ willingness to receive surgery,with statistical significance（P<0.05）．Logistic multifactor regression analysis showed that the patient’s financial burden,medical insurance reimbursement,and existing BPH complications were factors that affected the patient’s willingness to receive surgery．Conclusion sBPH patients in local region have financial burden,medical insurance and existing complications of BPH,which directly affect their willingness to undergo prostate surgery．Those factors not only affect the patients’ physical health but also affect the quality of theirlife and harmonious thier family relationships． Awareness of the disease should be increased to promote publicity,and patient mutual aid groups should be started to improve residents’ understanding of BPH disease and surgery and improve the quality of patients’life．

目的 探讨尿液前列腺特异性抗原（u-PSA）预测老年良性前列腺增生（BPH）发生急性尿潴留（AUR）的价值。方法 选取东莞市中医院100例老年BPH患者（2020年1月—2021年4月）进行回顾性研究,均口服盐酸坦索罗辛+非那雄胺片治疗,随访1年,记录AUR发生情况,据此分为AUR组、非AUR组。比较2组一般资料,Logistic回归模型分析老年BPH发生AUR的危险因素,受试者工作特征（ROC）分析前列腺体积（PV）、u-PSA对老年BPH发生AUR的预测价值。结果 100例老年BPH患者AUR发生率为26%;AUR组u-PSA水平高于非AUR组,PV大于非AUR组（P<0.05）;Logistic回归模型分析,u-PSA水平及PV增高是老年BPH患者发生AUR的独立危险因素（P<0.05）;ROC曲线分析,u-PSA预测AUR的AUC=0.897,高于AUC_PV（P<0.05）。结论 u-PSA可作为老年BPH继发AUR的量化评估指标,有利于临床早期筛查、诊断,采取针对性干预措施,改善预后。

Objective To investigate the value of urinary prostate-specific antigen（u-PSA）in predicting acute urinary retention（AUR）in elderly patients with benign prostatic hyperplasia（BPH）．Methods A total of 100 elderly patients with BPH in our hospital（from January 2020 to April 2021）were selected for a retrospective study,all of whom were treated with oral tamsulosin hydrochloride + finasteride tablets,followed up for 1 year,and the occurrence of AUR was recorded．The patients were divided into AUR group and non-AUR group．The general data of the two groups were compared．Logistic regression model was used to analyze the risk factors of AUR in elderly BPH patients,and receiver operating characteristic（ROC）was used to analyze the predictive value of prostate volume（PV）and u-PSA for AUR occurrence．Results The incidence of AUR in 100 elderly patients with BPH was 26%;the level of u-PSA in the AUR group was higher than that in the non-AUR group,and the PV was greater than that in the non-AUR group（P<0.05）．Increased PV was an independent risk factor for AUR in elderly patients with BPH（P<0.05）．ROC curve analysis showed that the AUC of u-PSA for predicting AUR was 0.897,which was higher than that of PV（P<0.05）．Conclusions u-PSA can be used as a quantitative evaluation index for AUR secondary to BPH in the elderly,which is conducive to early clinical screening and diagnosing,and taking targeted intervention measures to improve prognosis.

目的 探讨噻托溴铵喷雾剂(能倍乐)对合并有前列腺肥大(BPH)的慢性阻塞性肺疾病急性加重的影响。方法 2017年9月—2019年9月在我院呼吸与危重症医学科的AECOPD的男性患者167例,年龄51～96岁,平均(74.26±7.6)岁。分别为AECOPD组、AECOPD+噻托溴铵喷雾剂治疗组。比较AECOPD合并BPH与能倍乐的关系。结果 AECOPD患者合并有BPH的45人(52.94%),能倍乐治疗合并有BPH的AECOPD患者48人(58.53%),两组比较差异无统计学意义(P＞0.05)。其中,AECOPD患者合并有BPH患者中有10人(11.76%)出现尿频、夜尿多;尿潴留的4人(4.7%);同时口服哈乐和保列治的16人(18.82%);要置尿管导尿的5人(5.8%)。能倍乐治疗AECOPD患者合并有BPH患者中有7人(8.53%)出现尿频、夜尿多;尿潴留的1人(1.21%);同时口服哈乐和保列治的20人(24.39%);要置尿管导尿的3人(3.6%),比较差异均无统计学意义(P＞0.05)。结论 能倍乐不增加合并BPH的COPD患者的急性加重;也不增加治疗BPH的药物使用。能倍乐对于稳定期合并BPH的COPD患者治疗是安全的。

Objective To investigate the effect of Spiriva Respimat on acute exacerbation of COPD with benign prostatic hyperplasia(BPH). Methods The 167 patients who were hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD)(aged 51～96 years) with an average age of (74.26±7.6) years and the 82 patients treated with Spiriva Respimat in the department of respiratory and critical care medicine of our hospital from September 2017 to September 2019 were reviewed. In our pilot study, 48 AECOPD patients with BPH patients were enrolled as the treatment group and another 45 similar cases as the control group. In the former group Spiriva Respimat was administered and the control group was not. Results There were 45 patients (52.94%) with BPH in AECOPD group and 48 patients (58.53%) with BPH in Spiriva Respimat group. There was no statistical significance between the two groups (P>0.05). Among them, 10 patients (11.76%) with AECOPD and BPH had frequent urination and night urination, 4 patients (4.7%) of urinary retention, 16 patients (18.82%) who had oral Harnal and Finasteride, 5 patients (5.8%) need catheterization. In the AECOPD patients with BPH treated with Spiriva Respimat, 7 patients (8.53%) had frequent urination and night urination, 1 patient (1.21%) had urinary retention, 20 patients (24.39%) had oral Harnal and Finasteride, and 3 patients (3.6%) were managed through catheterization (P>0.05). Conclusion Spiriva Respimat does not increase the acute exacerbation of COPD patients with BPH, nor does it increase the use of drugs to treat BPH. It is safe to treat COPD patients with BPH in stable stage.

目的 探讨良性前列腺增生(BPH)并急性尿潴留(AUR)后血清肌酐、前列腺特异抗原(PSA)及其膀胱尿道功能的相关性及其临床意义。方法 对随机选择的36例已留置尿管48h以上的BPH并AUR患者进行尿流动力学检查,且同日行血清肌酐、PSA检测并分为两组:DI(逼尿肌不稳定)组(22例)和无DI组(14例),分析血清肌酐、PSA与膀胱功能各因素的相关性。结果 36例患者中逼尿肌收缩力很弱(VW)占10例,其游离PSA(fPSA)均<1.0 ng/mL,DI组中血清肌酐与膀胱顺应性、总PSA(tPSA)有相关性(r分别为0.406、-0.340,P值分别<0.01、0.05);DI幅度与膀胱顺应性、逼尿肌收缩力、tPSA有相关性(r分别为-0.309、0.677、0.304,P值分别<0.05、0.01、0.05);DI组与无DI组的fPSA与逼尿肌收缩力均有相关性(r分别为0.375、0.464,P值均<0.05)。DI组血清肌酐与fPSA、DI幅度、逼尿肌收缩力无相关性(r分别为-0.282、-0.301、-0.184,P值均>0.05);无DI组tPSA与血清肌酐、膀胱顺应性、逼尿肌收缩力无相关性(r分别为0.278、0.348、0.365,P值均>0.05)。结论 BPH并AUR患者的血清fPSA越低(<1.0 ng/mL),间接反映逼尿肌收缩力受损越严重,DI影响tPSA及肌酐水平。