国外文献对非那雄胺的安全性的解释（译）

下面在给大家一片相关的文献

Finasteride Improves The Sensitivity Of Digital Rectal Examination For Prostate Cancer Detection

UroToday.com- In the May, 2007 issue of the Journal of Urology, Dr. Ian Thompson and associates report that finasteride improves prostate cancer (CaP) detection with digital rectal examination (DRE). The authors hypothesized that finasteride would improve the detection of CaP by shrinking the prostate and resulting in a more sensitive DRE. They performed their study using the Prostate Cancer Prevention Trial database. The seven year study randomized men to finasteride 5mg daily or placebo and follow-up included prostate biopsies in those with increases in PSA or an abnormal DRE.

After exclusions, 4,579 participants in the finasteride arm, including 873 with biopsy for PSA >4.0ng/mlor abnormal DRE and 3,706 without either indication, and 5,112 in the placebo arm, including 1,012 with biopsy for increased PSA or abnormal DRE and 4,100 without either indication, were available for analysis. Indications for biopsy were usually either an elevated PSA or abnormal DRE, but rarely both. Increased PSA led to diagnosis of CaP in 33% of men on finasteride and 24% on placebo. In the 15.2% in the finasteride arm with the diagnosis of CaP, tumor grade was available in 686; Gleason 7 or higher occurred in 264 and Gleason 8 or higher in 81 men. In the 21.7% in the placebo arm diagnosed with CaP, tumor grade was available in 1,111; Gleason 7 or higher occurred in 240 and Gleason 8 or higher in 55 men.

DRE sensitivity was significantly higher for detecting CaP in men on finasteride compared to placebo (21.3% vs. 16.7%). A trend for increased DRE detection in high grade disease for those on finasteride existed as well, although it did not reach statistical significance. DRE specificity exceeded 90% in the two groups and was not different between the groups. DRE performed better for high-grade disease than for cancer overall in each group. Regardless of PSA level, DRE sensitivity for CaP detection was better in men on finasteride.

Thompson IM, Tangen CM, Goodman PJ, Lucia MS, Parnes HL, Lippman SM, Coltman Jr. CA

J Urol 2007; 177(5): 1749-52

   这篇文献是说非那雄胺是有助于提高直肠指检诊断前列腺癌的灵敏度的。这是一项长达7年的研究，虽没有显著统计学意义，但确实也说明了非那雄胺改善了直肠指检（DRE）诊断前列腺癌（CaP）。

   通过翻阅一些前列腺癌的文献和报道，可以很清楚的知道雄激素对前列腺癌的发展起决定性作用，而非那雄胺（5-α还原酶抑制剂）却可以直接影响雄激素的转化，所以它是一种很好的阻断前列腺癌进程的药物，并有助于早期检出高级别前列腺癌。

    在美国国家癌症研究所的研究也显示到，在18882名接受测试的男性当中，连续七年服用“非那雄胺”的男性患前列腺癌的几率少四分之一。所以朋友们我们应该庆幸是秃顶，让我们服用了非那，它不仅可以治疗我们的脱发问题，还解决了我们患上前列腺癌的风险！

   最后我还想纠正下大家一直对非那的另一项误解，就是它对我们性功能产生的障碍，我是学医的，也有过很多的临床上的经验，对于非那雄胺对性功能影响真是微乎其微，而且该影响也随时间减弱，可以和吸烟或高血压造成的影响相当，是远远低于衰老对性功能上的影响。因此，对性功能的影响我觉得不应作为阻碍使用非那雄胺治疗脱发等问题的因素。

    就说这么多吧！写这篇文章的目的也就是打消下一些和我一样正在服用非那治疗脱发朋友们的疑虑，我也不是在这里说非那就是好，怎么怎么的！对于它在治疗脱发上的效果，在我这里也确实的不是很好！说了这么多也就是希望不要因为不科学的一些谣言导致大家在治疗脱发的道路上又少了一种方式，当然我上面研究的这些，也只是一直围绕在前列腺癌的话题上，如果有朋友有更好的证据说明非那可以在其它方面会导致不好影响的，也请你上来说说！毕竟科学是建立在实际客观有说服力的证据之上的！