AUTONOMIC HYPERACTIVITY IN BENIGN PROSTATIC HYPERPLASIA

良性前列腺增生是影响男性最常见的肿瘤疾病，是影响美国人健康的主要因素。尽管治疗BPH的传统方法已经发展并被广泛接受，但药物治疗已经迅速出现了治疗具有BPH症状的患者的重要方式。 尽管肾上腺素能拮抗剂在BPH的治疗中广泛使用，但令人好奇的是，患者前列腺大小与其症状几乎没有相关性，并且观察到未经历手术或药物治疗的患者的BPH症状随着时间的推移具有广泛的波动，并且60-70%的患者将对肾上腺素能治疗具有有利的短期反应。 这表明膀胱颈梗阻的功能成分受到强烈的自主神经张力的影响。 我们建议对BPH患者的自主神经系统功能状态进行评估。 我们认为，自主神经活性亢进的基线张力和交感神经系统的反应性是影响BPH的症状，并可能在患者的症状进展的因果关系。 将通过测量血浆去甲肾上腺素、心率、血压、对循环应激的反应、24小时尿儿茶酚胺、一系列症状评分、前列腺大小测量、排尿后残留、最大尿流率、腹部脂肪测量、血清C肽水平和体力活动回忆表，研究BPH症状的交感神经系统活动过度的评估。

Benign prostatic hyperplasia is the most common neoplastic condition affecting men and constitutes a major health factor impacting Americans. Although traditional approaches to treat BPH have evolved and are widely accepted medical therapy has quickly emerged a significant modality for treating patients with symptoms of BPH. Despite adrenergic antagonists, widespread use in the treatment of BPH it is curious that patients prostate size has little correlation to their symptoms and patients who are observed without undergoing surgery or medical treatment have wide fluctuations in symptoms of BPH over time and 60-70% of patients will have a favorable short term response to adrenergic therapy. This suggests that the functional component of bladder neck obstruction is being influenced by strong autonomic tone. We propose to carry out an assessment of the functional state of the autonomic nervous system in our BPH patients. We propose that autonomic hyperacitivity as measured by baseline tone and reactivity of the sympathtic nervous system is influencing the symptoms of BPH and may have a causal relationship in patients' symptomatic progression. The assessment of the sympathetic nervous system hyperactivity on BPH symptoms will be investigated by the measurement of plasma norepinephrine, heart rate, blood pressure, response to circulatory stress, 24 hour urinary catecholamines, a series of symptom scores, measurements of prostate size, post void residual, maximum urinary flow rate, measurement of abdominal fat, serum C-peptide levels, and physical activity recall forms.