前列腺增生症病人合的前列腺炎症对血清前列腺特异性抗原的影响.doc
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前列腺增生症病人合并的前列腺炎症对血清前列腺特异性抗原的影响
【摘要】 目的:探讨前列腺增生症合并的前列腺炎症对病人血清PSA的影响。方法:纳入2006年9-12月期间在四川大学华西医院行经尿道前列腺电切术的前列腺增生症病人52例,术前检查经直肠前列腺B超,检测血清前列腺特异性抗原,记录年龄和是否存在急性尿潴留;术中取切取的前列腺组织采用real-time PCR检测前列腺感染与否。采用Logistic多元回归方法,纳入尿潴留、前列腺感染、前列腺体积和年龄等因素的同时,分析前列腺腺周炎症、前列腺腺体炎症是否与血清前列腺特异性抗原浓度有关。结果:前列腺腺周炎症、前列腺体积与血清PSA升高有关(P值分别为0.027和0.001)。结论:除了前列腺体积外,前列腺腺周炎症是前列腺增生症病人血清PSA升高的危险因素。
【关键词】 前列腺增生症;炎症;前列腺特异性抗原
Abstract Objective: To study the effect of prostatic inflammation on prostate-spacific antigen(PSA) level in the serum of the patients with benign prostatic hyperplasia(BPH). Methods: Fifty-two in-patients with BPH were enrolled from September to December 2006 in West China Hospital of Sichuan University. Transrectal ultrasonography was performed and serum total prostate-specific antigen was tested before transurethral resection of prostate. Deep random prostatic gland tissue were collected after resection of the prostatic urethra by the resectoscope sheath under the sterile condition for testing bacterial 16S rDNA by real-time PCR and the pathologic examination. Results: Rise in serum prostate-specific antigen level was associated with periglandular inflammation and prostatic volume in the multivariable logistic regression analysis (P=0.027 and 0.001 respectively). Conclusions:It was demonstrated in the present study that, apart from prostatic volume, periglandular inflammation was a causal factor for the rise in PSA level.
Key words Benign prostatic hyperplasia;Inflammation;Prostate-specific antigen
既往研究显示前列腺增生症(benign prostatic hyperplasia,BPH)患者前列腺炎症普遍存在[1]。关于BPH病人合并的前列腺组织学炎症影响血清前列腺特异性抗原(prosatic-specific antigen,PSA)没有一致意见。而阐明上述问题对于避免不必要的前列腺穿刺活检具有较好的临床意义。Stancik等[2]研究表明慢性无症状前列腺炎症使病人血清PSA升高。但此研究没有纳入前列腺炎症程度和前列腺体积。而研究前列腺炎症对血清PSA的影响应该考虑炎症程度、前列腺体积等影响因素,此外需排除前列腺穿刺因素的可能影响。
为了进一步探讨前列腺组织学炎症是否对血清PSA浓度产生影响,在考虑尿潴留、前列腺感染、前列腺体积以及病人年龄等因素的情况下,我们采用Logistic多元回归方法分析前列腺炎症(包括炎症程度和主要的炎症类型)对BPH病人血清PSA的影响。
1 对象与方法
1.1 对象选择 以2006年9-12月在四川大学华西医院行经尿道前列腺电切术(transuret
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