良性前列腺增生合并前列腺炎患者的临床特点分析

目的 探讨合并前列腺炎的良性前列腺增生(BPH)患者的临床特点. 方法 BPH患者100例.按是否合并前列腺炎分为单纯组(34例)和合并组(66例).比较2组患者年龄、前列腺体积、PSA与前列腺特异性抗原密度(PSAD)、国际前列腺症状评分(IPSS)的差异,同时分析B超检查对BPH合并前列腺炎的检出情况. 结果单纯组患者年龄为(66.5±6.4)、合并组为(69.9±7.2)岁;单纯组平均前列腺体积为(47.5±26.7)、合并组为(71.4±39.3)ml.单纯组患者PSA和PS-AD中位数分别为3.40和0.08 ng/ml,合并组分别为8.07和0.12 ng/ml;平均IPSS分别为19.9和22.2.2组患者平均年龄、前列腺体积、PSA与PSAD值及IPSS评分比较,差异均有统计学意义(P<0.05).合并前列腺炎患者前列腺体积与炎症浸润程度及腺体破坏程度具有相关性(r分别为0.29,0.25,P<0.01).PSA与前列腺炎浸润分级和破坏分级均具有相关性(r分别为0.319和0.214,P值均<0.05).PSAD与浸润分级具有相关性(r=0.212,P<0.05).B超诊断BPH合并前列腺炎的敏感性为21.2%,特异性82.4%. 结论 BPH患者多伴前列腺炎,且以慢性炎性细胞浸润为主;合并前列腺炎的患者临床检测指标明显高于单纯BPH患者.B超对BPH合并前列腺炎的检出能力不令人满意.

BPH combined with prostatitis:differences in clinical characters

Objective To analysis the differences of age, prostate volume, serum PSA and PSAD, IPSS between the BPH and BPH with prostatitis. Methods Clinical data of 100 patients whom received surgical treatments with a pathologic diagnosis of BPH were retrospectively analyzed. The occurrence of prostatitis was determined by pathology. The differences of age, prostate volume, serum PSA and PSAD, IPSS between the BPH cases and BPH with prostatitis cases were analyzed. The capability of B-ultrasound in diagnosis of the prostatitis combined with BPH was evaluated. Re-suits 66% BPH patients were found combined with prostatitis. There was a significant correlation between inflammatory infiltration grade and aggressiveness grade (r= 0. 772, P<0. 001). There was a moderate correlation between prostate volume and patient age(r= 0. 420, P<0. 001). There was a low correlation between serum PSA and patient age (r= 0. 258, P<0. 01) while no significant correla-tion between PSAD and age. The patient age of BPH combined with prostatitis group was significantly higher than BPH group (P<0. 05). Average prostate volume of combined with prostatitis group was significantly higher than BPH group (P<0. 05). There was a significant correlation between prostate volume and inflammatory infiltration grade(r=0. 292, P=0. 003), PSA and aggressiveness grade(r=0. 254, P=0.007). Both average PSA and PSAD of BPH combined with prostatitis group were signif-icantly higher than the BPH group (P<0. 05). When the factor of difference in age distribution was considered, the conclusion were still valid (P<0.05). On α= 0.05 level, relatively low correlations were found between PSA and inflammatory infiltration grade(r=0. 319, P=0. 001), PSA and aggres-siveness grade(r=0. 214, P=0. 032), PSAD and inflammatory infiltration grade ( r=0. 212, P=0. 034). There was no significant correlation between PSAD and aggressiveness grade(r=0.081 ,P=0.425). Average IPSS of combined with prostatitis group were significantly higher than BPH group. On diagnosis of the combined prostatitis in BPH, the sensitivity of ultrasonic was 21.2% with a speci-ficity of 82.4%. Conclusions Prostatitis is often found in more than half BPH samples. The BPH with prostatitis usually has bigger prostate volume, higher PSA, PSAD and may present relatively se-verer clinic syndromes.