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肾移植受者良性前列腺增生的横断面研究

Cross-sectional study of benign prostatic hyperplasia in kidney transplant recipients

摘要:

目的 研究肾移植受者良性前列腺增生(benign prostatic hyperplasia,BPH)的发病率及发病危险因素. 方法 2007年1月至2012年12月,≥50岁稳定期男性肾移植受者197例,分为50~ 59岁(87例)、60~69岁(64例)和≥70岁(46例)3个研究组;在社区随机选取相应年龄段人群240名作为健康对照组,50~59岁94名,60~69岁81名,≥70岁65名.采用横断面研究法调查肾移植受者BPH发病率;检测外周血角化生长因子(kasatinocyte growth factor,KGF)、转移生长因子β(transforming growth factor-β,TGF-β)、血清睾酮的表达水平和CD4/CD8值. 结果 肾移植受者组BPH总发病率为16.2%(32/197),其中50~ 59岁组发病率为6.9%,60 ~ 69岁组发病率为18.8%,≥70岁组发病率为30.4%.与健康对照组相比,肾移植受者血清睾酮(9.4±4.7与18.2±5.6,P=0.040)和CD4/CD8值(1.1±0.3与1.8±0.3,P=0.014)水平显著降低;TGF-β的表达水平(5015±1087与1829±963,P<0.001)显著升高;KGF表达水平(35.8±20.7与21.0±18.3,P=0.064)差异无统计学意义.结论 肾移植受者BPH的发病率低于同年龄段健康人群,可能与免疫抑制剂影响TGF-β、KGF的表达、睾酮水平和淋巴细胞浸润有关.

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abstracts:

Objective To investigate the incidence of and risk factors for benign prostatic hyperplasia (BPH) in transplant recipients.Methods 197 males aged 50 years and older who received kidney transplants were recruited if they were clinically stable.They were divided into three age groups:50 to 59 years (87 cases),60 to 69 years (64 cases) and ≥ 70 years (46 cases).Two hundred and forty people who had not undergone kidney transplant were randomly selected from the community as controls.A cross-sectional study was performed to study the BPH incidence in kidney transplant recipients according to standard diagnostic criteria.At the same time,the expression levels of keratinocyte growth factor,transforming growth factor-β and serum testosterone and the CD4/CD8 ratio in T lymphocytes were determined.Results There was no significant difference in age,PSA and the postmicturition residual volume between the study group and the control group.The total BPH incidence in kidney transplant recipients was 16.2% (32/197).The symptomatic BPH incidence was 6.9% (6/87) in the 50-to 59-year-old study group and 20.2% (19/94) in the control group,representing a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.010).The symptomatic BPH incidence was 18.8% (12/64) in the 60-to 69-year-old study group and 41.9% (34/81) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.004).The symptomatic BPH incidence was 30.4% (14/46) in the ≥ 70-year-old study group and 52.3% (34/65) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.032).Compared to the control group,the peripheral blood serum testosterone level (9.4 ± 4.7,18.2 ± 5.6,P =0.040) and the CD4/CD8 ratio (1.1±0.3,1.8±0.3,P=0.014) of kidney transplant recipients was lower.The transforming growth factor-β expression level (5015± 1087,1829±963,P<0.001) was higher in kidney transplant recipients than in the control group.The kasatinocyte growth factor expression levels (35.8±20.7,21.0± 18.3,P =0.064) was not statistically different than in the control group.Conclusions Kidney transplant recipients who had long-term administration of calcineurin inhibitor might have a low benign prostatic hyperplasia incidence,which might be related to transforming growth factor-β and keratinocyte growth factor expression,testosterone levels and the lymphocyte infiltration.Further high-quality prospective studies are still needed to confirm the conclusions.

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