前列腺液免疫球蛋白测定对慢性前列腺炎的诊断价值

本文应用单向免疫扩散法（ＳＲＩＤ）测定了８６例慢性前列腺炎患者的前列腺液中ＩｇＡ、ＩｇＧ含量。结果显示炎性前列腺液ＩｇＡ、ＩｇＧ与健康人比较均有明显增高（Ｐ＜０．０１），经中药前列腺汤治疗后，ＩｇＡ可见明显降低（Ｐ＜０．０５）。前列腺质地类型与前列腺液免疫球蛋白的变化相关。     

前列腺液IAP和SIgA测定与临床应用

慢性前列腺炎是男性泌尿生殖系统的常见病及多发病 ,其中绝大多数属慢性非细菌性前列腺炎 ,其病因诊断及治疗较为困难 ,确切病因至今尚未明确。为了探讨免疫因素在慢性非细菌性前列腺炎中的作用 ,我们检测了 60例慢性非细菌性前列腺炎病人前列腺液中的免疫抑制因子 (ｉｍｍｕｎｏｓｕｐｐｒｅｓｓｉｖｅａｃｉｄｉｃｐｒｏｔｅｉｎ ,ＩＡＰ)和分泌型免疫球蛋白Ａ(ＳＩｇＡ) ,现报告如下。1　资料与方法1 1　临床资料　病例组 60例慢性非细菌性前列腺炎病人 ,均为门诊病例 ,年龄 19～ 52岁 ,平均 30 6岁。有不同程度的尿频、排尿不适、会阴…     

多聚酶链反应对病毒性前列腺炎的检测研究

为探讨病毒性前列腺炎的病原学，采用多聚酶链反应（ＰＣＲ）技术对７４例慢性非细菌性前列腺炎的前列腺液进行单纯疱疹病毒Ⅱ型（ＨＳＶⅡ）检测。结果：前列腺液中ＨＳＶⅡ阳性率为１６．２％，对照组均为阴性（Ｐ＜０．０１）。４例前列腺液ＨＳＶⅡ阳性者，前列腺按摩前初始尿和尿道粘膜脱落细胞ＰＣＲ检测均为阴性。结果进一步证实了病毒是非细菌性前列腺炎的重要病因之一，ＰＣＲ技术对病毒性前列腺炎的临床诊断、治疗及疗效判定有重要意义。     

非细菌性前列腺炎中医药治疗的预后与转归

非细菌性前列腺炎中医药治疗的预后与转归陈乃光非细菌性前列腺炎以无尿路感染史、男性下尿路细菌定位培养（Ｍｅａｒｅｓ－Ｓｔａｍｅｙ法）阴性，只是前列腺按出液中含有大量白细胞，每高倍视野中多于１０个为特征。应与慢性细菌性前列腺炎相鉴别，后者需符合以下两点，...     

慢性非细菌性前列腺炎患者前列腺组织中细菌16SrRNA基因和大肠杆菌tufA mRNA基因的检测

目的 探讨细菌感染与慢性非细菌性前列腺炎的相关性。方法 应用PCR方法检测慢性非细菌性前列腺炎患者前列腺组织中的细菌16SrRNA基因，同时用RT-PCR方法检测其中的大肠杆菌tufAmRNA基因。结果 38例慢性非细菌性前列腺炎患者前列腺组织中31例（81．5％）呈细菌16SrRNA基因阳性；在31例细菌16SrRNA基因阳性的患者前列腺组织中，有6例（19．4％）检出大肠杆菌tufAmRNA基因。结论 慢性非细菌性前列腺炎患者的前列腺组织中不仅有细菌的存在，而且部分被证实是活力细菌。细菌在慢性非细菌性前列腺炎的病因中可能起一定的作用。     

慢性非细菌性前列腺炎症状与前列腺液中白介素-10水平的关系

目的 探索诊断慢性非细菌性前列腺炎和评价其疗效的方法。方法 对A、B两组患者前列腺液（EPS）中自介素-10（IL-10）水平与症状进行相关性分析。结果 A、B两组患者EPS中IL-10水平明显升高，A组比B组升高更为明显，差异有统计学意义（P〈0．01）。表明EPS中IL-10水平与慢性非细菌性前列腺炎症状有相关性。结论 患者EPS中IL-10水平可以作为诊断慢性非细菌性前列腺炎和评价其疗效的依据。     

慢性前列腺炎患者前列腺液中前列腺特异性抗原的变化

目的测定慢性前列腺炎患者前列腺特异性抗原（ＰＳＡ）在前列腺液中的变化,以探讨其对此类疾病诊断的意义。方法对５５例慢性前列腺炎及１１例泌尿外科非前列腺炎疾病患者的前列腺液进行常规检查、细菌培养和ＰＳＡ光密度值（ＯＤ值）检测。结果实验组的ＰＳＡ水平较对照组明显升高（Ｐ＜０．０１）,而在细菌性及非细菌性前列腺炎时ＰＳＡ水平无明显变化,实验组与对照组卵磷脂小体差异有极显著性（Ｐ＜０．０００５）,实验组前列腺液中的白细胞计数与ＰＳＡ相关系数ｒ＝０．２,Ｐ＜０．０４。结论慢性前列腺炎时前列腺液中的ＰＳＡ可增高,ＰＳＡ可作为诊断慢性前列腺炎的一个辅助指标。     

氧自由基在前列腺炎发病中的作用

前列腺炎综合征 (Ｐｒｏｓｔａｔｉｔｉｓｓｙｎｄｒｏｍｅ ,ＰＳ)可分为急性细菌性前列腺炎 (ＡＢＰ)、慢性细菌性前列腺炎 (ＣＢＰ)、慢性非细菌性前列腺炎 (ＣＮＰ)前列腺痛(ＰＤ)。本文仅测定了ＡＢＰ、ＣＢＰ、ＣＮＰ病人血清的丙二醛 (ＭＤＡ)含量、超氧化物歧化酶 (ＳＯＤ)活力水平 ,旨在探讨氧自由基在前列腺炎发病过程中的作用。资料与方法一、研究对象与分组收集尿液常规异常及培养出细菌的ＡＢＰ病人2 5例 ;收集前列腺液镜检ＷＢＣ >10个 /ＨＰ、卵磷脂小体减少、或镜检正常但临床有症状的病人共 6 1例 ,其中包括前列腺液培养出…     

慢性非细菌性前列腺免疫学病因

目的：探讨慢性非细胞性前列腺炎有关自身免疫方面的病因。方法：对３３例性非细菌性前列腺炎患者进行血清和前列腺免疫抑制因子（ＩＡＰ）、白细胞介素６（ＩＬ－６）、白细胞介素８（ＩＬ－８）的检测作为病例组,并对１６例健康男性也进行此三项指标检测作为对照。结果：病例组前列腺液中ＩＡＰ含量明显较血清低,对照组没有此变化。两组前列腺液和血清中ＩＬ－６、ＩＬ－８针明显变化。结论：ＩＡＰ与本病的发生有关,而ＩＬ－６     

前列腺液内毒素测定在慢性前列腺炎诊治的意义

测定４７例慢性前列腺炎，１５例前列腺痛病人和１１例对照者中段尿（ＶＢ２，称标本１），前列腺按摩后前列腺液和尿液（ＶＢ３，与ＥＰＳ合称标本２）内毒素浓度，同时作细菌培养。结果表明，革兰阴性菌或Ｇ＾－菌合并革兰阳性菌性前列腺炎患者标本２的内毒素浓度较标本１升高非常显著高于对照组和前列腺痛组（Ｐ＜０．００１），显著高于Ｃ＾＋菌性慢性前列腺炎或细菌数低于低于诊断标准的慢性前列腺炎患者（Ｐ＜０．０５）；Ｇ＾     

Cryptic bacterial infection in chronic prostatitis: diagnostic and therapeutic implications

Chronic idiopathic prostatitis, sometimes called prostatodynia or abacterial prostatitis, is a commonly diagnosed and poorly treated urological syndrome. Clinically, this condition frustrates the patient and physician due to its chronicity and resistance to therapy. Recent studies suggest that the etiology of chronic idiopathic prostatitis may be of bacterial origin. Three types of provocative data have demonstrated bacterial presence from prostatic specimens (tissue and secretions) that were negative by traditional clinical microbiologic tests: (i) presence of bacterial gene sequences in prostatic tissue encoding 16S rRNA and tetracycline resistance (tetM-tetO-tetS); (ii) controlled cultural findings showing coagulase-negative staphylococci as the most common isolates (68%) in prostatodynia (chronic idiopathic prostatitis); and (iii) culture of difficult-to-grow coryneforms in expressed prostatic secretions (EPS) on enriched culture media and direct microscopic observation of these pleomorphic bacteria in EPS. Additionally, earlier experimental studies in a rat model support the concept that antibiotic therapy in chronic bacterial prostatitis may not be due to altered antibiotic pharmacokinetics in the chronically inflamed prostate gland. Rather, ineffective antimicrobial eradication might result from protected bacterial micro-colonies within an infection-induced altered micro-environment deep within the prostate gland. We postulate that extracellular slime substances produced by bacteria that are buried in prostatic tissues could impair host defenses by their anti-phagocytic and anti-chemotactic properties that affect neutrophils as well as anti-proliferative characteristics that affect lymphocytes. These extracellular slime substances could also have cytoprotective properties which can conceal bacteria from otherwise bactericidal levels of antibiotics and lead to recrudescent infections resistant to therapy. Persistence of bacterial antigens might initiate a cascade of cellular immunologic events resulting in chronic inflammation of the prostate gland.     

Cytologic findings of fine needle aspirates in chronic prostatitis

Cytologic studies in patients with prostatic infection, primarily those with chronic prostatitis, were conducted on samples obtained by the fine needle aspiration method. Infiltration of inflammatory cells such as polymorphonuclear leukocytes and macrophages was observed to a greater extent in patients with chronic bacterial prostatitis as compared to those with chronic nonbacterial prostatitis or prostatodynia. The pathogen was isolated in only one out of 28 patients with chronic bacterial prostatitis. We concluded that fine needle biopsy is useful for assessing patients with prostatic inflammation, but not for detecting microorganisms because of focal colonization of the organisms in the glands.     

Measurement of urinary antibodies to crude bacterial antigen in patients with chronic bacterial prostatitis

Measurements of IgG and IgA antibodies against common gram negative organisms in pre and post prostatic massage urines were investigated. Lower tract urinary localization specimens were obtained in men with chronic bacterial prostatitis, nonbacterial prostatitis, and without evidence of infection. Quantitative cultures were performed on all specimens. A rapid and simple enzyme-linked immunosorbant assay (ELISA) was developed to measure urinary total immunoglobulins and antibodies to common gram negative organisms (mixed antigen-specific antibodies, MASA). Comparison with a previously developed radioimmunoassay yielded a correlation determinant of 0.89 per cent. Almost all patients had post prostatic massage urinary IgA and IgG levels that were higher than the premassage levels, reflecting the presence of prostatic fluid in the postmassage specimens. In only the patients with chronic bacterial prostatitis, however, were levels of IgA or IgG MASA in the postmassage urines higher than those measured in the premassage urines. This same elevation was found in the urinary specimens from men who could not be diagnosed to have bacterial prostatitis by traditional means on a specific occasion because of antibiotic treatment, inadequate specimens, or bacteriuria, but had chronic bacterial prostatitis confirmed traditionally on another occasion. No detectable MASA were measured in either the pre or postmassage urines of men without a history of previous urinary infections. From these data it appears that urinary MASA may be used to diagnose bacterial prostatitis in situations in which quantitative bacteriologic cultures cannot be performed. These measurements may, furthermore, be used to diagnose chronic bacterial prostatic infection in men who cannot be diagnosed to have bacterial prostatitis when prostatic fluid is unobtainable or culture results are uninterpretable.     

慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中的细菌16SrRNA基因检测

目的:探讨细菌在慢性非细菌性前列腺炎病因中的作用,评估细菌16S核糖体核糖核酸(16SrRNA)基因在前列腺液标本和前列腺组织标本中检出的差异.方法:应用PCR方法检测38例慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中细菌16SrRNA基因,同时对照检测尿道拭子和直肠拭子以及穿刺枪头拭子的细菌16SrRNA基因.结果:细菌16SrRNA基因的检出率在前列腺液中和前列腺组织中分别为 78.9%和81.5%(P＞ 0.05).细菌基因信号在前列腺液标本中和尿道拭子中各有30例( 78.9%)和4例( 10.5%)呈阳性(P＜ 0.01);在前列腺组织中和直肠拭子中各有31例( 81.5%)和6例( 15.8%)呈阳性(P＜ 0.01),无一例穿刺枪头拭子阳性.结论:慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中均有细菌16SrRNA基因的检出,其病因可能与细菌感染有关. 细菌16SrRNA基因的检出在前列腺液标本和前列腺组织标本中差异无统计学意义.     

Pathogenesis of chronic bacterial prostatitis in an animal model

A reproducible rat model of chronic bacterial prostatitis was developed using a defined bacterial pathogen (Escherichia coli) to study the pathogenesis and persistence of chronic bacterial prostatitis. The progression of inflammation and its consequences from acute to chronic prostatitis were documented with microbiological, histological, ultrastructural and immunological data. Chronic bacterial prostatitis in this model was associated with sparse glycocalix-enclosed protected bacterial microcolonies within the prostatic acini and ducts which appeared to stimulate a persistent local and systemic immunological reaction resulting in chronic inflammation of the gland. This model has many striking similarities to the natural history of human chronic bacterial prostatitis.     

Coagulase-negative staphylococcus in chronic prostatitis.

Three male patients with a clinical history of prostatitis with coagulase-negative staphylococci localized to the expressed prostatic secretion and who did not respond to antibiotics were studied intensively 4 weeks after cessation of therapy with repeat culture of the prostatic fluid, as well as with culture, and histological and ultrastructural examination of multiple prostatic biopsies. Coagulase-negative staphylococci were cultured in the biopsied prostatic tissue, and gram-positive staphylococci were identified in sparse and focal microcolonies adherent to the prostatic ductal walls. Coagulase-negative staphylococci may be implicated in the pathogenesis of chronic bacterial prostatitis.     

Does the chronic prostatitis/pelvic pain syndrome differ from nonbacterial prostatitis and prostatodynia?

PURPOSE: The new consensus classification considers the chronic prostatitis/pelvic pain syndrome (CPPS) based on presence or absence of leukocytes in the expressed prostatic secretions, post-massage urine or seminal fluid analysis. We compared classification based on evaluation of these 3 specimens to the traditional classification based on expressed prostatic secretion examination alone. MATERIALS AND METHODS: A prospective clinical and laboratory protocol was used to evaluate symptomatic patients who had no evidence of urethritis, acute bacterial prostatitis or chronic bacterial prostatitis. RESULTS: Thorough clinical and microbiological evaluation of 310 patients attending our prostatitis clinic was used to select a population of 140 subjects who provided optimal expressed prostatic secretion, post-massage urine and semen specimens. Inflammation was documented in 111 (26%) of 420 samples, including 39 expressed prostatic secretion samples with 500 or greater leukocytes/mm.3, 32 post-massage urine samples with 1 or greater leukocytes/mm.3 and 40 seminal fluid specimens with 1 or greater million leukocytes/mm.3. Of the 140 subjects 73 (52%) had inflammatory chronic prostatitis/pelvic pain according to the consensus criteria but only 39 (28%) had nonbacterial prostatitis according to traditional expressed prostatic secretion criteria (p <0.001). CONCLUSIONS: The new consensus concept of inflammatory chronic prostatitis/pelvic pain includes almost twice as many patients as the traditional category of nonbacterial prostatitis.     

Tc-99m ciprofloxacin imaging in diagnosis of chronic bacterial prostatitis

Aim:To investigate the value of Tc-99m ciprofloxacin imaging in the differential diagnosis of chronic bacterial prostatitis. Methods: The study included 4 normal subjects as the negative controls, 2 patients with acute prostatitis or cystourethritis as the positive controls and 59 patients diagnosed as chronic bacterial prostatitis or chronic pelvic pain syndrome by traditional laboratory tests. In every subject, the single photon emission computer-ized tomography images were obtained 3 h after intravenous injection of Tc-99m Ciprofloxacin. The results of the imaging were compared with those of laboratory tests. Results: On the images, negative uptake was observed in all normal subjects, while strong hot uptake, in the whole prostate of acute prostatitis patients and in the whole urethra of acute cystourethritis patients. In 13 (68 %) of 19 patients categorized as chronic bacterial prostatitis by standard laboratory tests, hot uptake with less intensity than that of acute prostatitis was observed in the prostate area around the prostatic urethra. Negative uptake in the prostate was observed in 6 of 19 patients (32 %) categorized as chronic bacterial prostatitis. Interestingly, hot uptake in the prostate was exhibited in 28 (70 %) of the 40 patients categorized as chronic pelvic pain syndrome. Conclusion: Tc-99m ciprofloxacin imaging is helpful in the differential diagnosis of prostatitis syndrome. (Asian J Androl 2003 Sep; 5:179-183 )     

早泄病人慢性前列腺炎的发生率调查

目的 :调查早泄男性中慢性前列腺炎的发生率。　方法 :对 10 6例早泄病人和 38例正常人前列腺按摩前后尿液标本及前列腺按摩液 (EPS)进行显微镜和 /或细菌学检查 ,并评估 12 0例慢性前列腺炎病人中早泄的发生率。　结果 :在早泄病人中发现 49例 (46 .2 %)有慢性前列腺炎 ,其中 34 .7%存在慢性细菌性前列腺炎 ,与对照组相比均有统计学差异 (P <0 .0 5 )。 12 0例慢性前列腺炎病人中 5 7例 (47.5 %)存在不同程度的早泄。　结论 :本研究结果提示慢性前列腺炎症在某些早泄病人的发病机制中可能具有一定作用 ,在针对早泄治疗前进行前列腺仔细检查具有重要意义。     

良性前列腺增生合并慢性前列腺炎组织中SIgA、α1-AR的表达与意义

目的:了解良性前列腺增生(BPH)合并慢性前列腺炎(CP)组织中SIgA、α1-AR的表达及意义。方法:将62例行经尿道前列腺等离子电切组织标本,根据术前前列腺按摩液(EPS)常规、经直肠前列腺B超、血清前列腺特异抗原(PSA)、国际前列腺症状评分(IPSS)、临床症状以及有无慢性骨盆疼痛综合征以及术后组织病理检查结果分为单纯BPH、BPH合并慢性前列腺炎两组。采用免疫组化、RT-PCR等实验方法研究两组前列腺组织中SIgA、α1-AR的表达。结果:62例患者中30例为BPH合并慢性前列腺炎,32例为单纯BPH,通过对患者一般资料对比和对实验结果进行统计学分析,合并慢性前列腺炎的BPH患者SIgA、α1-AR表达显著高于单纯BPH患者(0.380 8±0.144 3 vs 0.295 4±0.008 4;0.440 5±0.104 1 vs 0.383 2±0.013 6),差异有统计学意义(P<0.05)。结论:SIgA、α1-AR在BPH合并慢性前列腺炎患者中的表达上调,提示慢性前列腺炎与BPH可能有一定的内在联系,炎症反应可能是BPH的一个致病因素,与BPH的病理发展过程有关。