抗炎治疗后NIH-Ⅳ型前列腺炎患者血清PSA的变化

PSA value changes after antibacterial therapy in NIH-Ⅳ prostatitis patients

目的:探讨抗炎治疗后美国国立卫生院(NIH)-Ⅳ型前列腺炎患者血清前列腺特异性抗原(PSA)的变化。方法:对经筛选符合入选标准的68例、PSA增高(≥4μg/L)、拟行前列腺穿刺活检的NIH-Ⅳ型前列腺炎患者,予左氧氟沙星(0.5,口服,1/d)+复方磺胺甲恶唑片(SMZ)(1.0,口服,2/d)治疗2周,治疗后复查PSA和前列腺液(EPS)。分析PSA的变化及其与治疗效果(EPS中WBC≤10/HP为有效,WBC>10/HP为无效)的关系。结果:68例患者治疗前PSA值为(9.76±4.26)μg/L,治疗后为(4.32±2.92)μg/L(P<0.01),其中治疗有效28例(P<0.01)。治疗后PSA<4μg/L的患者26例,其中治疗有效23(P<0.01);治疗后仍PSA≥4μg/L的患者42例,其中治疗有效5例。结论:抗炎治疗2周后患有NIH-Ⅳ型前列腺炎、PSA≥4μg/L患者,血清PSA值明显下降,超过1/3患者血清PSA下降至正常而免于前列腺穿刺活检;PSA的下降与抗炎治疗效果相关。

Objective：To explore the change of Prostatic-specific antigen（PSA） value after antibacterial therapy in patients with National Institutes of Health（NIH）-Ⅳ prostatitis. Methods：Of the prostatic carcinoma screening patients who were going to undergo transrectal-ultrasound guided needle biopsies of the prostate because of abnormal PSA（≥4.00 μg/L）, the NIH-Ⅳ prstatitis patients were given Levofloxacin 0.5 once a day＋ Sulfamethoxazole（SMZ） 1.0 twice a day for two weeks and then redeterminated the serum PSA and expressed prostatic secretion（EPS）. The change of the PSA value and its relation to therapeutic efficacy（WBCs in the EPS≤ 10/HP was regarded as effective,WBCs in the EPS〉 10/HP was regarded as ineffective） were analysed. Results： A total of 68 patients were included in the study. The PSA value was 9.76 ± 4.26 μg/L before antibacterial therapy and decreased significantly to 4. 32± 2.92 μg/L after antibacterial therapy for two weeks（ P 〈0.01）. Of them the therapeutic efficacy of 28 patients was effective（ P 〈0.01）. The PSA value decreased to 〈 4 μg/L in 26 patients after antibacterial therapy whose PSA value changed from 9.21 ±3.98 ng/ml to 2.32 ±1.27 ng/ml（ P 〈0.01） and the treatment was effective in 23 patients （ P 〈0.01）. Of the 42 patients whose PSA value was ≥4 μg/L and PSA value changed from 10.65±4.94 μg/L to 9.52 ±3.06 μg/L（ P 〉0.05）, the treatment was effective in 5 patients （ P 〉0.05）. Conclusions：The PSA value decrease significantly after antibacterial therapy for two weeks in patients with NIH-Ⅳ prostatitis with PSA≥4 μg/L. More than one third patients whose PSA value drop down to normal can avoid biopsies. The change of PSA value is relative to the efficacy of antibacterial therapy.