THE EFFECT OF NAFARELIN ACETATE, A LUTEINIZING-HORMONE-RELEASING HORMONE AGONIST, ON BENIGN PROSTATIC HYPERPLASIA
THE EFFECT OF NAFARELIN ACETATE, A LUTEINIZING-HORMONE-RELEASING HORMONE AGONIST, ON BENIGN PROSTATIC HYPERPLASIA
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DOI：
10.1056/nejm198709033171004
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发表时间：
1987-09-03
影响因子：
158.5
通讯作者：
WALSH, PC
中科院分区：
文献类型：
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作者：
PETERS, CA;WALSH, PC
我们研究了雄激素对良性前列腺增生的影响，使用醋酸那法瑞林，一种有效的促黄体激素释放激素激动剂，在良性前列腺增生的男性中实现可逆的雄激素剥夺。在开放试验中，用皮下醋酸那法瑞林（400 μ g/天）治疗9名患有由于良性前列腺增生引起的膀胱出口梗阻的患者6个月。在所有患者中，血清睾酮下降到去势水平。客观观察包括尿流率测定、残余尿量测量、超声测量前列腺大小和前列腺活检。在所有患者中，前列腺退化至平均（±）。SEM）为75.8 .+-。3%的初始大小（范围，52至86; P < 0.005）;四个月后回归达到平台。活检标本的形态学分析显示腺上皮退化。9例患者中有3例在治疗后临床改善。停止治疗6个月后，血浆睾酮水平恢复正常，前列腺的大小增加到99 . ±. 5.5初始大小的百分比。这些发现表明雄激素对良性前列腺增生有重要的支持作用，睾丸抑制对某些患者有益。然而，这种形式的治疗只能适用于精心挑选的不适合手术的患者，而且需要无限期地维持。
We examined the influence of androgens on benign prostatic hyperplasia, using nafarelin acetate, a potent luteinizing-hormone-releasing hormone agonist, to achieve reversible androgen deprivation in men with benign prostatic hyperplasia. Nine patients with bladder-outlet obstruction due to benign prostatic hyperplasia were treated with subcutaneous nafarelin acetate (400 .mu.g per day) in an open trial for six months. In all patients, serum testosterone decreased to castrate levels. Objective observations included uroflowmetry, measurement of residual urine volume, determination of prostatic size by ultrasonography, and prostatic biopsy. In all patients, the prostate regressed to a mean (.+-. SEM) of 75.8 .+-. 3 percent of the initial size (range, 52 to 86; P < 0.005); the regression reached a plateau after four months. Morphological analysis of biopsy specimens showed regression of glandular epithelium. Three of nine patients had clinical improvement with treatment. Six months after the cessation of treatment, plasma testosterone levels had returned to normal and the size of the prostate had increased to 99 .+-. 5.5 percent of the initial size. These findings suggest that androgens have an important supportive role in established benign prostatic hyperplasia and that testicular suppression will benefit some patients. However, this form of treatment could be applicable only in carefully selected patients who were not surgical candidates, and it would need to be maintained indefinitely.