前列腺增生患者膀胱出口梗阻与血清PSA的相关性研究

Relationship between bladder outlet obstruction and serum prostatic specific antigen in patients with benign prostatic hyperplasia

目的探讨前列腺增生(BPH)患者膀胱出口梗阻(BOO)和血清前列腺特异抗原(PSA)的相关性。方法对253例伴有下尿路症状的BPH患者行尿流动力学、国际前列腺症状评分(IPSS)和血清PSA检查。结果根据膀胱出口梗阻指数(BOOI)将患者分为三组,分别为BOO组156例,轻度BOO组61例,无BOO组36例;术前血清总PSA(tPSA)分别为(4.54±1.71)μg/L(、2.45±1.74)μg/L(、1.85±1.71)μg/L,BOO组与另两组之间差异有统计学意义;术前IPSS评分分别为(20.6±5.1)分(、17.5±4.5)分、(17.6±4.7)分,BOO组与另两组之间差异有统计学意义;术前剩余尿量(PVR)分别为(104.5±37.1)ml、(106.7±41.7)ml、(105.1±41.1)ml,三组之间差异无统计学意义。结论血清PSA作为一个简单的检测指标,可部分反映膀胱出口梗阻的严重性,结合IPSS、尿流率和B超,对BPH治疗选择和预后判断具有指导意义。

Objective To investigate the relationship between bladder outlet obstruction （BOO） and serum prostatic specific antigen （PSA） in patients with benign prostatic hyperplasia （BPH）. Methods The study of pressure- flow urodynamic examination, IPSS score and serum PSA were performed in 253 cases with BPH. Results Based on the bladder outlet obstruction index （BOOI）, all patients were divided into three groups： Definite BOO group had 156 patients, mild 13OO group had 61 patients, no BOO group had 36 patients. The data of tPSA were （4.54 ±1.71）μg/L, （2.45 ±1.74） μg/L and （ 1.85 ± 1.71 ） μg/L respectively, there were significant differences between definite BOO group and other two groups （P 〈 0.05）. The IPSS score before operation were 20.6 ±5.1, 17.5 ±4.5 and 17.6 ±4.7 respectively, there were significant differences between definite BOO graoup and other I two groups （P〈0.05）. The PVR before operation were （104.5±37.1） ml, （106.7±41.7） ml and （105.1± 41.1） ml respectivdy, there were no significant differences between the groups （P 〉0.05）. Conclusion As a easy detection index , serum PSA may partially reflect the severity of BOO, combined with IPSS score, uroflow, type of B supersonic wave, it would give some guide for patients with BPH to select therapies and judge the prognosis.