服用非那雄胺治疗脱发，会致癌吗？

    近日在一些网站和论坛看到有人在讨论“服用非那雄胺会导致癌症的报道！”对于这种话题本人觉得应该大家起来讨论下，毕竟对于脱发来说，目前非那雄胺可能是公认算比较有效果的一种治疗脱发的药物！

    个人觉得，要聊这个话题还是先从基本的开始讲起，毕竟还是有很多朋友并不是很清楚非那雄胺到底是什么！这个非那到底起着什么作用？非那为何会在治疗脱发上会有效果？下面我挑出几个朋友们经常问我的几个关于非那雄胺的问题，不熟悉非那雄胺的朋友先在前面了解下再说！

1.非那雄胺是什么？
    非那雄胺是一种药物的名称，它也叫非那司提、非那甾胺，为何会有这么中文名，这个只能说是翻译的问题，因为它的英文学名是Finasteride

2.保法止、保列治、启悦是什么？
    这是三个不同厂家制作的非那雄胺药物的商品名！就是说他们都做非那雄胺，但是叫的名不一样，另外在制作的工艺流程上有一定的区别！

3.非那雄胺到底是治脱发的还是治前列腺的？
     既然你问了这个问题说明你已经也在网上查过了！这么说吧！非那雄胺既治脱发又治前列腺，因为在治疗的原理上都一样的，都是抑制体内睾酮向双氢睾酮的转变（简单说就是不让它转变成另一种形态） 至于说为何非那雄胺会起到这样的作用，我简单说下！因为在睾酮转变成为二氢睾丸酮的时候，这时细胞内会产生一种Ⅱ型5α还原酶的细胞内酶,而恰好非那就是抑制这种酶产生的一种4氮杂甾体化合物！

4.看过第3点问题已后，相信会有很多人问，睾酮和双氢睾酮（也叫二氢睾丸酮）和脱发有什么关系？
    原因就是上面说的，在睾酮转变成为二氢睾丸酮时，产生含有Ⅱ型5α还原酶，这种酶会使男性秃发患者的秃发区头皮内毛囊变少，秃发区增加了双氢睾酮。所以遗传性的脂溢性脱发的真正幕后元凶便是这个“5α还原酶”。所以先天性缺乏Ⅱ型5α还原酶的男子不会患男性秃发的！

5.那么非那雄胺为什么会治愈脱发！
    我想这个问题在您认真看过我的3、4两点应该是明白了！再简单点说就是非那雄胺可使此类脱发患者头皮及血清中的双氢睾酮浓度下降，抑制头皮毛囊变小同时抑制和转变脱发的情况！

   讲到这里大家对非那雄胺有了一定了解了吧！包括它在治疗脱发方面的作用机制！那么下面就说下今天的主题“服用非那雄胺会导致癌症”！

    对于这样的问题，我认为要以科学的角度去分析它！对于无凭无据，瞎编乱造的文字，我希望不要在出现！其实想在这里说这个问题，主要原因是本人也在用非那，看的这样的标题我顿时心里慌乱不堪，毕竟这关系着本人的生命！

    通过本人在医学上的一些认识和了解，再加上一些文献的翻阅，我认为这样的说法实属谣言！目前还没一例是因为脱发问题服用非那而导致出现癌症的患者，对于非那是否会导致癌症的命题始终都是围绕在患有前列腺疾病的患者这边，和我们这些脱发的人基本没有什么关系。有兴趣的朋友先看下下面这段文献

Prostate Cancer Risk Among Users Of Finasteride And Alpha-Blockers A Population Based Case Control Study
>
UroToday.com- Current medical management for BPH includes alpha-blockers and 5 reductase inhibitors. In the Prostate Cancer Prevention Trial, finasteride, a 5 reductase inhibitor was shown to decrease the risk of developing prostate cancer by 24.8% over 7.2 years. Dr. Murtola and colleagues report in the online version of the European Journal of Cancer, a population based study evaluating the risk of CaP among men undergoing BPH therapy.

The Finnish Cancer Registry was used to identify 25,029 men with newly diagnosed CaP. The Population Register Center of Finland selected 24,723 male age and geographical controls. Information on BPH therapy was obtained from the prescription database of the Social Insurance Institution of Finland. A logistic regression model was used to calculate odds ratios.

A total of 7,715 men had used BPH therapy, and 1,578 had used both blockers and 5 reductase inhibitors. Finasteride use was greater among cases than controls. Finasteride was associated with an increased CaP risk. The risk was increased among short-term users regardless of length of the analyzed time period. Risk of CaP among finasteride users did not differ from that of the non-users. Finasteride use for less than 4 years was associated with an increased risk for localized CaP. This risk of advanced CaP was not affected by finasteride.

Alpha-blocker use was associated with increased CaP risk. The risk remained elevated regardless of regularity of use or length of the analyzed time period. The risk increase was stronger among men 60 years of age or younger, as compared to 77 years of age and older. Overall, the risk among users of both drug categories was increased compared with that among non-users. When compared to alpha-blocker users, the overall CaP risk in finasteride users was decreased. The significant decrease was observed for regular and irregular users.

This is the first study to evaluate CaP risk among finasteride users in a population-based setting and compare it to that of alpha-blocker users. An increased risk of CaP existed for users of either BPH therapy. The investigators attribute the risk increase to increased detection of latent CaP due to differential diagnostics of BPH. They state that the CaP risk in symptomatic finasteride users is strongly affected by not only the biological effect of finasteride, but by the clinical practices and diagnostics in the management of BPH.

Teemu J. Murtola, Teuvo L.J. Tammela, Liisa M??tt?nen, Matti Hakama and Anssi Auvinen

Eur J Cancer 2007, 43(4): 775-781
Reviewed by UroToday.com Contributing Editor Christopher P. Evans, MD

   具体的内容我就懒得给大家翻译了，概述下这段文献的意思是，他们认为在症状性非那雄胺使用者中，前列腺癌的危险性不仅仅受非那雄胺生物学效应的显著影响，也受临床实践和前列腺增生治疗中的诊断学影响。