非那雄胺治疗经尿道前列腺切除术中出血的Meta分析_《中国循证医学杂志》

作者：

朱育春 ¹ , 钟玲 ² , 魏强 ¹

1. 四川大学华西医院泌尿外科（成都 610041） 2. 四川大学华西临床医学院;

关键词：

非那雄胺经尿道前列腺切除术出血良性前列腺增生（症） Meta分析

DOI：

10.7507/1672-2531.20080104

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　评价非那雄胺治疗经尿道前列腺切除术中出血的效果。
方法　按Cochrane 协作网工作手册的要求，制定相应的纳入/ 排除标准及检索策略。检索MEDLINE（1966～2005）、EMbase（1984～2004）、CBM（1980～2005）、Cochrane 图书馆（2005 年第4期）以及相关杂志和学位论文，收集非那雄胺治疗经尿道前列腺切除术中出血的随机和非随机对照试验。对纳入的试验进行方法学质量评价。采用统一的表格由两名评价员独立进行资料提取，用RevMan4.2 软件进行数据处理和分析。
结果　最终纳入5篇文献：4 个为随机对照试验，1个为非随机对照试验。3个随机对照试验的质量等级均为C级。Meta分析结果显示，两组年龄、下尿路症状评分、前列腺特异抗体水平及术前前列腺体积、术中切除组织量均可比（P gt;0.05）的情况下，非那雄胺组术中出血量［WMD –85.44，95%CI（–117.31，–53.58）］、每克切除前列腺组织出血量［WMD –3.5，95%CI（–6.34，–0.58）］，术前术后血色素降低量［WMD – 1.61，95%CI（–1.96，–1.26）］均少于对照组。
结论　现有证据表明，行经尿道前列腺切术前服用非那雄胺能有效减少术中出血。

引用本文： 朱育春,钟玲,魏强. 非那雄胺治疗经尿道前列腺切除术中出血的Meta分析. 中国循证医学杂志, 2008, 08(6): 456-460. doi: 10.7507/1672-2531.20080104 复制

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11.	Gormley GJ, Stoner E, Bruskewitz RC, et al. For the Finasteride Study Group: The effect of finasteride in men with benign prostatic hyperplasia. N Engl J Med, 1992, 327: 1185-1191.
12.	Marshall S, Narayan P. Treatment of prostatic bleeding: suppression of angiogenesis by androgen deprivation. J Urol, 1993, 149: 1553-1554 .
13.	Puchner PJ, Miller MI. The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a prel iminary report. J Urol, 1995, 154: 1779-1782.
14.	Hochberg DA, Basillote JB, Armenakas NA, et al. Decreased suburethral prostatic microvessel density in finasteride treated prostates: a possible mechanism for reduced bleeding in benign prostatic hyperplasia. J Urol, 2002, 167: 1731-1733.
15.	Luke M, Kvist E, Anderson F, et al. Reduc postoperative bleeding after transurethral resectioprostate by local instillation of fibrin adhesive. BeBr J Urol, 1986, 58: 672-675.
16.	Foley SJ, Bailey DM. Microvessel density in prostatic hyperplasia. BJU Int, 2000, 85(1): 70-73.
17.	Szewczyk W. Blood loss during transurethral resection of the prostate injected with phenol solution. Int Urol Nephrol, 1991, 23: 155-159.
18.	Levine AC, Liu XH, Greenberg PD, et al. Androgens induce the expression of vascular endothel ial growth factors in human fetal prostatic fibroblasts. Endocrinology, 1998, 139: 4672-4678 .
19.	Franck-Lissbrant I, Haggestrom S, Damber JE, et al. Testosterone stimulates angiogenesis and vascular regrowth in the ventral prostate in castrated adult rats. Endocrinology, 1998, 139: 451-456.
20.	Buttyan R, Ghafar MA, Shabsigh A. The effects ofandrogen deprivation on the prostate gland: cell death mediated by vascular regression. Curr Opin Urol, 2000, 10: 415-420.
21.	Weingartner K, Ben-Sasson S, Stewart R, et al. Endothel ial cell prol iferation activity in benign prostatic hyperplasia and prostate cancer: an in vitro model for assessment. J Urol, 1998, 159: 465-470.
22.	Senger DR, Gall i SJ, Dvorak AM, et al. Tumor cells secrete a vascular permeabil ity factor that promotes accumulation of ascites fluid. Science, 1983, 219(4587): 983-985.
23.	Moon SY, Moon WC, Hak R, et al. Finasteride inhibits angiogenesis and expression of VEGF in human BPH. J Urol, 1998, 159(suppl): 332, abstract 1276.
24.	Miller MI, Puchner PJ. Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up. Urology, 1998, 51: 237-240.

1. Dull P, Reagan RW Jr, Bahnson RR, et al. Managing Benign ProstaticHyperplasia. Am Fam Physician, 2002, 66(1): 77-84.
2. Puchner PJ, Miller MI. The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a prel iminary report. J Urol, 1995, 154: 1779-1782.
3. Higgins J, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6[updated month year]. The Cochrane Library, Issue 4, 2006. Chichester: Wiley. Updated quarterly.
4. 李幼平, 刘鸣. 循证医学—21世纪的临床医学. 实用医学杂志, 2000, 16: 517-521.
5. Peter Juni, Anne Witschi, Ralph Bloch T, et al. he hazards of scoring the qual ity of cl inical trials for meta-analysis. JAMA, 2000, 282: 1054-1060.
6. Crea G, Sanfil i ppo G, Anastasi G, et al. Pre-surgical finasteride therapy in patients treated endoscopically for benign prostatic hyperplasia. Urologia Internationalis, 2005, 74(1): 51-53.
7. Donohue JF, Sharma H, Abraham R, et al. Transurethral prostate resection and bleeding: a randomized, placebo controlled trial of role of finasteride for decreasing operative blood loss. J Urol, 2002, 168: 2024-2026.
8. 李恭会, 何正富, 余大敏, 等. 非那雄胺对经尿道前列腺切除术中出血和冲洗液吸收影响的定量性研究. 浙江大学学报 (医学版), 2004, 33(3): 258-260.
9. 刘孝东, 杨宇如, 卢一平, 等. 非那雄胺减少TURP术中出血的机理研究. 中华泌尿外科杂志, 2003, 10(24): 694-696.
10. Ozdal OL, Ozden C, Benl i K, et al. Effect of short-term finasteride therapy on reoperative bleeding in patients who were candidates for transurethral resection of the prostate (TUR-P): a randomized controlled study. Prostate Cancer Prostatic Dis, 2005, 8(3): 215-218.
11. Gormley GJ, Stoner E, Bruskewitz RC, et al. For the Finasteride Study Group: The effect of finasteride in men with benign prostatic hyperplasia. N Engl J Med, 1992, 327: 1185-1191.
12. Marshall S, Narayan P. Treatment of prostatic bleeding: suppression of angiogenesis by androgen deprivation. J Urol, 1993, 149: 1553-1554 .
13. Puchner PJ, Miller MI. The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a prel iminary report. J Urol, 1995, 154: 1779-1782.
14. Hochberg DA, Basillote JB, Armenakas NA, et al. Decreased suburethral prostatic microvessel density in finasteride treated prostates: a possible mechanism for reduced bleeding in benign prostatic hyperplasia. J Urol, 2002, 167: 1731-1733.
15. Luke M, Kvist E, Anderson F, et al. Reduc postoperative bleeding after transurethral resectioprostate by local instillation of fibrin adhesive. BeBr J Urol, 1986, 58: 672-675.
16. Foley SJ, Bailey DM. Microvessel density in prostatic hyperplasia. BJU Int, 2000, 85(1): 70-73.
17. Szewczyk W. Blood loss during transurethral resection of the prostate injected with phenol solution. Int Urol Nephrol, 1991, 23: 155-159.
18. Levine AC, Liu XH, Greenberg PD, et al. Androgens induce the expression of vascular endothel ial growth factors in human fetal prostatic fibroblasts. Endocrinology, 1998, 139: 4672-4678 .
19. Franck-Lissbrant I, Haggestrom S, Damber JE, et al. Testosterone stimulates angiogenesis and vascular regrowth in the ventral prostate in castrated adult rats. Endocrinology, 1998, 139: 451-456.
20. Buttyan R, Ghafar MA, Shabsigh A. The effects ofandrogen deprivation on the prostate gland: cell death mediated by vascular regression. Curr Opin Urol, 2000, 10: 415-420.
21. Weingartner K, Ben-Sasson S, Stewart R, et al. Endothel ial cell prol iferation activity in benign prostatic hyperplasia and prostate cancer: an in vitro model for assessment. J Urol, 1998, 159: 465-470.
22. Senger DR, Gall i SJ, Dvorak AM, et al. Tumor cells secrete a vascular permeabil ity factor that promotes accumulation of ascites fluid. Science, 1983, 219(4587): 983-985.
23. Moon SY, Moon WC, Hak R, et al. Finasteride inhibits angiogenesis and expression of VEGF in human BPH. J Urol, 1998, 159(suppl): 332, abstract 1276.
24. Miller MI, Puchner PJ. Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up. Urology, 1998, 51: 237-240.

《中国循证医学杂志》

非那雄胺治疗经尿道前列腺切除术中出血的Meta分析

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《中国循证医学杂志》

非那雄胺治疗经尿道前列腺切除术中出血的Meta分析

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