Prostate Cancer Prostatic Dis:体外冲击波治疗慢性前列腺炎/慢性盆腔疼痛综合征的疗效及临床预测因素

2021-11-05 AlexYang MedSci原创

调查了ESWT治疗CPPS效果以及可能影响其疗效的临床特征。

慢性盆腔疼痛综合征(CPPS)是一种特发性疾病,其特点是无定点的局部盆腔疼痛,且在引起排尿症状前六个月中,疼痛至少持续三个月。CPPS会影响患者的生活质量(QoL),甚至影响性功能

近期,来自埃及的研究人员在《Prostate Cancer Prostatic Dis》上发表一篇文章,调查了ESWT治疗CPPS效果以及可能影响其疗效的临床特征。

在2017年1月至2021年1月期间,研究人员对155名成年慢性盆腔疼痛综合征患者进行了前瞻性随机临床研究。所有患者都进行了病史和体格检查。使用NIH-CPSI评分、IPSS、VAS和IIEF-5评分评估了每个参与者的基线症状。

患者被随机分为两组:verum治疗组和安慰剂治疗组。Verum治疗组的患者接受ESWT治疗,每周一次,每次3000个脉冲,持续4周。安慰剂组的患者接受相同设备的治疗,但冲击波被一层充满空气的微球吸收。在完成ESWT治疗后的1个月、3个月、6个月和12个月的定期随访中,研究人员对参与者进行了重新评估。

结果发现,在随访期间,Verum组患者的NIH-CPSI、IPSS、VAS和IIEF-5的平均得分有明显改善,两组之间的差异也有统计学显著。在ESWT治疗后的第一次随访中,63名(82.8%)患者的NIH-CPSI总分下降≥6分,13名(17.2%)患者没有上述情况。

研究人员通过对有反应者和无反应者的临床特征进行单变量和多变量分析发现,那些有心理障碍史或NIH-CPSI初始得分较高的患者,对ESWT的反应率明显较低(分别为p=0.005, 0.02和p=0.002, 0.004)。NIH-CPSI评分的ROC曲线显示,32分是对ESWT反应下降的分界点。

Verum组中,有反应者和无反应者的基线特征比较

综上所述,ESWT是CPPS的一种有效的治疗方案。其疗效在整个长期随访过程中均保持。另外,起始的NIH-CPSI分数和心理问题史是疗效的重要预测因素

原始出处:

Ahmed M Sakr , Amr M Fawzi , Mostafa Kamel et al. Outcomes and clinical predictors of extracorporeal shock wave therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome: a prospective randomized double-blind placebo-controlled clinical trial. Prostate Cancer Prostatic Dis. Oct 2021

 

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    2022-06-09 anan
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  4. 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encodeId=84f61364e6263, content=<a href='/topic/show?id=7c5615628ad' target=_blank style='color:#2F92EE;'>#ROS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15628, encryptionId=7c5615628ad, topicName=ROS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=acc3210, createdName=lsndxfj, createdTime=Sat Nov 06 10:04:07 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432182, encodeId=49e1143218221, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, 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  5. 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encodeId=84f61364e6263, content=<a href='/topic/show?id=7c5615628ad' target=_blank style='color:#2F92EE;'>#ROS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15628, encryptionId=7c5615628ad, topicName=ROS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=acc3210, createdName=lsndxfj, createdTime=Sat Nov 06 10:04:07 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432182, encodeId=49e1143218221, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Nov 06 10:04:07 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602397, encodeId=7d52160239e25, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Nov 06 10:04:07 CST 2021, time=2021-11-06, status=1, ipAttribution=)]
    2022-09-02 DEXTER3139
  6. 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  7. 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  8. 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    2021-11-06 lsndxfj
  9. 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  10. 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