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目的:调查上海市社区40～70岁中老年男性下尿路症状(LUTS)的患病率及前列腺各项参数随增龄变化的规律。方法:2009年11月至2010年6月对上海市9个居委1 000例40～70岁的常住居民,运用整群及年龄分层的流行病学随机抽样方法,通过国际前列腺症状评分(IPSS)调查该人群中LUTS的患病率;经直肠超声检测其前列腺及移行带的左右径、前后径、上下径,并拟合前列腺随年龄的生长规律。结果:在40～49岁、50～59岁和60～70岁年龄组中,中、重度LUTS(IPSS≥8)患病率分别为10.0%、15.0%和28.7%,LUTS症状随年龄增加而明显上升。超声检测显示:前列腺及其移行带的左右径、前后径、上下径和体积均随年龄增长而增大,各年龄组存在统计学意义(P<0.05);对左右径、前后径和上下径各参数值拟合生长速度方程分别为Y=1.6×10-5X3-0.002 1X2+0.074 6X+0.677 2、Y=-2.4×10-5X3+0.003 3X2-0.131 2X+1.269、Y=1.6×10-5X3-0.001 8X2+0.073X-0.690 9。显示前列腺的左右径及前后径生长速度较为均衡,在60岁以前左右径的生长速度明显快于上下径,而60岁以后上下径的生长速度迅速上升且超过左右径的速度。结论:上海市社区中老年男性LUTS患病率接近于国内外情况,前列腺各径线生长速度呈现不均衡性,60岁以前以左右径生长为主,而60岁以后则以上下径生长为主。
Objective: To investigate the prevalence of lower urinary tract symptoms (LUTS) and the changes of prostatic gland parameters with age in middle-aged and elderly men aged 40-70 years in Shanghai community. METHODS: From November 2009 to June 2010, 1,000 resident 40- to 70-year-old residents in 9 neighborhoods in Shanghai were recruited. The epidemiological random sampling method was used to divide the patients into three groups according to the International Prostate Symptom Score IPSS) was used to investigate the prevalence of LUTS in this population. The diameter of the prostate, the anteroposterior diameter, the diameter of the prostate and the diameter of the transitional zone were measured by transrectal ultrasound and the growth of the prostate was fitted with age. Results: The prevalences of moderate and severe LUTS (IPSS≥8) were 10.0%, 15.0% and 28.7% in the age groups of 40-49, 50-59 and 60-70 respectively. The symptoms of LUTS increased with age Significantly increased. Ultrasound examination showed that the left and right diameter, anteroposterior diameter, anteroposterior diameter, and anteroposterior diameter of the prostate and its transition zone increased with age, with statistical significance in all age groups (P <0.05) The fitted growth rate equations for each parameter were Y = 1.6 × 10-5X3-0.002 1X2 + 0.074 6X + 0.677 2, Y = -2.4 × 10-5X3 + 0.003 3X2-0.131 2X + 1.269, Y = 1.6 × 10- 5X3-0.001 8X2 + 0.073X-0.690 9. The diameter of the prostate and the diameter of the anteroposterior diameter of the prostate are relatively balanced. The growth rate of the diameter of the left and right before 60 years old is obviously faster than that of the upper and lower diameters, while the growth speed of the upper and lower diameter after the age of 60 rises rapidly and exceeds the speed of the left and right diameter. Conclusion: The prevalence of LUTS in middle-aged and elderly men in Shanghai community is close to that of domestic and foreign countries. The growth rate of each diameter of the prostate presents an imbalance, with the growth of left and right before 60 years old and the growth of upper and lower kidney after 60 years old .