전립선조직내 염증이 전립선비대증 치료에 미치는 영향

Other Titles
The Effect of Intraprostatic Chronic Inflammation on Benign Prostate Hyperplasia Treatment
Authors
권영기
Issue Date
2009-12
Awarded Date
2010
Abstract
전립선조직내 만성 염증이 전립선비대증의 약물 치료에 미치는 영향을 알아보고자 하였다. 대상 및 방법 : 2005년 9월부터 2008년 6월까지 전립선조직검사상 만성 염증소견이 있으며 전립선비대증으로 진단받고 알파차단제와 5알파환원효소억제제로 약물 치료를 시작하였던 환자 중 6개월이상 추적이 가능한 82례를 대상으로 하였다. 전립선조직내 만성 염증정도에 따라 저등급군 38례(46%)와 고등급군 44례(54%)로 나누어 치료 전, 약물치료 후 1, 3, 6, 12개월의 IPSS, QOL 및 수술여부를 비교하였다. 만성 염증정도에 따라 나눈 저등급군과 고등급군에서 치료 전 IPSS는 각각 19.94점, 18.16점, QOL은 4.10점, 3.56점으로 두 군간 차이는 없었다(p>0.05). 저등급군에서 치료 후 1, 3, 6, 12개월 IPSS 호전정도는 각각 -6.68점, -8.15점, -10.25점, -9.73점으로 6개월까지 연속적인 호전이 보였는데 비해, 고등급군에서는 각각 -5.00점, -6.68점, -6.76점, -6.28점으로 3개월까지 IPSS의 연속적인 호전이 보였다. 두 군간의 통계적 차이는 없었다 (p>0.05). 저장증상의 호전정도는 저등급군에서 치료 후 1, 3, 6, 12개월에 각각 -2.47점, -3.15점, -3.94점, -4.00점으로 6개월까지 연속적인 호전이 보였으나, 고등급군에서는 각각 -2.16점, -2.36점, -2.32점, -2.08점으로 1개월까지 호전을 보였으며 이후 큰 변화는 없었다. QOL의 호전은 치료 전과 비교하여 두 군에서 모두 유의하게 있었으며 (p<0.05), 저등급군에서는 3개월에 최저치를 보였으나 고등급군에서는 6개월에 최저치를 보였다. 저등급군에서는 치료 6개월 이후에 약물 치료에 실패한 경우는 없었으나 고등급군은 4례 (9.1%)에서 약물치료 실패로 경요도전립선절제술을 받았다. 전립선조직내 만성 염증이 저등급인군에서는 치료실패로 전립선 수술을 경우는 없었으나 고등급군은 9.1%가 전립선 수술을 받았다. 통계적 유의성은 없으나 저등급군에서 IPSS 호전이 많았고 좀 더 오랫동안 지속적이었다. 향후 전립선비대증 치료 시 조직내 염증 치료에 대한 추가적인 연구가 필요할 것으로 생각된다. Asymptomatic chronic inflammation in prostate is common finding in patients with benign prostate hyperplasia (BPH). We investigated how the chronic inflammation in prostate affect on medical treatment of BPH. This retrospective study enrolled 82 BPH patients whose transrectal ultrasonography (TRUS)-guided needle biopsy showed chronic inflammation and began treating with alpha adrenergic blocker or/and a 5-alpha reductase inhibitor and these treatments lated at least 6months. The extent of chronic inflammation was classified into 4 grades, categorized into two groups: 38 cases (46%) in low grade (chronic inflammation grade 0, I) and 44 cases (54%) in high grade (chronic inflammation grade II, III). We compared the differences between the two groups for their initial International Prostate Symptom Score (IPSS), Quality of Life (QOL) and IPSS and QOL of after medical treatment in 1, 3, 6, 12 months. There was no significant difference in initial IPSS and QOL between low and high group. In low grade group, the improvement of IPSS after medical treatment in 1, 3, 6, 12 months were -6.68, -8,15, -10.25, -9.73, showed consecutive improvement for 6 months. However, in high grade group -5.00, -6.68, -6.76, -6.28, showed consecutive improvement for 3 months. There was no statistical difference between low and high groups (p>0.05). The improvement of irritative symptom score in low grade were -2.47, -3.15, -3.94, -4.00 and were -2.16, -2.36, -2.32, -2.8 in high grade. There was consecutive improvement for 6 months in low grade group. In low grade group, the maximal improvement of QOL was showed at 3 months, however in high grade group, was showed at 6 months. 4 cases (9.1%) were received surgery for acute urinary retention (AUR) or insufficients therapeutic response in high grade group. Our study found that there was no case of surgery for therapeutic failure in low grade group, however, in high grade group, 9.1% received surgery. Although there was no statistical significance, the improvement of IPSS was higher and longer in low grade inflammation. We are consider the necessity of medical treatment for intraprostatic chronic inflammation in BPH patients.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/11675
Appears in Collections:
3. Thesis (학위논문) > 1. School of Medicine (의과대학) > 석사
Full Text
http://dcollection.kmu.ac.kr//jsp/common/DcLoOrgPer.jsp?sItemId=000000008946
File in this Item
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE