特拉唑嗪在Ⅲ_B型前列腺炎治疗中的应用

The study of Terazosin in the treatment of chronic prostatitis Ⅲ_B

目的:观察特拉唑嗪治疗ⅢB型前列腺炎的临床疗效,并测定治疗前后前列腺液中前列腺素E2(PGE2 )的表达水平,探讨其发生的可能机制。方法:根据NIH分类法筛选出ⅢB型前列腺炎患者46例(治疗组),应用特拉唑嗪进行治疗,每天2mg,连服4周。治疗前后分别进行NIH CPSI评分及尿流率测定,并应用ELISA方法对对照组及治疗组部分患者治疗前后的前列腺液标本进行PGE2 浓度测定。采用t检验及简单相关性分析对所测数据进行统计学处理。结果:①治疗组治疗前PGE2 浓度均明显高于正常对照组,差异有统计学意义(P<0. 05)。②治疗后PGE2 浓度与治疗前比较差异有统计学意义(P<0. 05)。③NIH CPSI评分治疗后每个变量与治疗前比较差异均有统计学意义(P<0. 05)。④尿流率各治疗后每个变量与治疗前比较差异均有统计学意义(P<0. 05)。结论:ⅢB型前列腺炎患者前列腺液中PGE2 的表达水平与其发生及症状的严重程度有密切的相关性。特拉唑嗪可降低前列腺液中PGE2 的表达水平,对缓解其引发的疼痛症状及改善排尿症状有很好的疗效。

Objective:To investigate the mechanism of chronic prostatitis (CP) and define the best guidance for its clinical treatment by studying the efficacy of Terazosin and also detecting the expression of Prostaglandin E_2(PGE_2) in expressed prostatic secretion (EPS).Methods:Standardized clinical surveys were completed in 46 patients who met the criteria for CP by physical examination, urine and EPS analysis and urine culture, including 46 cases of CP Ⅲ_B which were treated with alpha 1-adrenoceptor antagonist(Terazosin)for 4 weeks. Symptom scores (NIH-CPSI) and urodynamic indexes were recorded and the expression of PGE_2 in EPS of CP patients and normal asymptomatic controls were detected by enzyme-linked immumosorbent assay pre- and post-treatment.Results:Mean levels of PGE_2 in EPS were significantly higher in treated arms than in normal controls before treatment (P< 0.05). Mean levels of PGE_2 in EPS of post-treatment group were significantly lower than those of pre-treatment counterparts (P< 0.05). NIH-CPSI after treatment were significantly lower than that before treatment (P< 0.05), Urodynamic indexes of post-treatment were significantly lower than those of pre-treatment counterparts (P< 0.05).Conclusions:The results of the present study indicate that the levels of PGE_2 in EPS may play an important role in CP and are associated with symptoms of CP. Alpha 1-adrenoceptor antagonist (Terazosin) significantly reduced the levels of inflammation factors such as PGE_2 and may improve the efficacy in the treatment of CP.