良性前列腺增生合并慢性前列腺炎的临床特点分析

目的:探讨良性前列腺增生(BPH)合并慢性前列腺炎(CP)患者的临床特点。方法:将行经尿道前列腺电切术(transurethral resection of the prostate,TURP),术后病理诊断证实为BPH的患者120例,按是否合并CP分为单纯BPH组(简称单纯组,75例)和BPH合并CP组(简称合并组,45例)。结合术前经直肠超声检查及f-PSA、t-PSA、f-PSA/t-PSA检测结果,并根据公式计算出前列腺总体积(TPV)、PSA密度(PSAD),进行统计和分析。结果:单纯组患者,随着年龄或前列腺体积的增加,f-PSA及t-PSA均呈上升趋势,差异有统计学意义(P<0.05),但f-PSA/t-PSA值及PSAD差异无统计学意义(P>0.05)。合并组患者,随着年龄的增加,f-PSA及t-PSA各组间比较差异有统计学意义(P<0.05),随着前列腺体积的增加,f-PSA及t-PSA各组间比较差异有统计学意义(P<0.05),均呈上升趋势,但f-PSA/t-PSA值及PSAD各组间比较差异无统计学意义(P>0.05)。合并组患者较单纯组患者的f-PSA、t-PSA及PSAD有所上升,差异有统计学意义(P<0.05),但f-PSA/t-PSA值变化不大,差异无统计学意义(P>0.05)。通过对各项指标做ROC工作曲线分析发现,f-PSA、t-PSA、PSAD 3项指标的曲线下面积分别为0.644、0.628、0.624,均介于0.5至0.7之间。结论:BPH患者常合并CP,临床中f-PSA、t-PSA升高,同时伴PSAD升高的BPH患者,应考虑合并前列腺炎的可能性大,上述3个指标作为诊断BPH伴CP的依据有一定的意义,但并不是十分可靠。

Clinical features of benign prostatic hyperplasia complicated by chronic prostatitis

Objective:To explore the clinical characteristics of benign prostatic hyperplasia(BPH) complicated by chronic prostatitis(CP).Methods:A total of 120 cases of BPH pathologically confirmed after transurethral resection of the prostate(TURP) were assigned to a BPH group(n = 75) and a BPH+CP group(n = 45) according to whether they were complicated by CP.The total prostatic volume(TPV) and PSA density(PSAD) were calculated and statistically analyzed based on the results of transrectal ultrasonography and f-PSA,t-PSA and f-PSA/t-PSA tests before surgery.Results:The BPH group showed a significantly upward tendency in f-PSA and t-PSA(P < 0.05) with the increase of age or prostate volume,but not significantly in PSAD and f-PSA/t-PSA(P > 0.05).In comparison,the BPH+CP group exhibited remarkable increases in f-PSA,t-PSA and PSAD(P < 0.05) but not in f-PSA/t-PSA(P > 0.05).ROC curve analyses of various indexes showed the area under the curve to be 0.644,0.628 and 0.624 for f-PSA,t-PSA and PSAD,respectively,all between 0.5 and 0.7.Conclusion:BPH is frequently associated with CP.Clinically,high f-PSA,t-PSA and PSAD are important but not sure indicators of BPH complicated by CP.Natl J Androl,2010,16(9):830-833