前列腺液16s rDNA检测在慢性前列腺炎诊治中的临床意义

Evaluation of 16s rDNA detection in EPS for clinical diagnosis and therapy of patients with chronic prostatitis

目的探讨前列腺液16s rDNA检测对慢性前列腺炎的临床诊断和治疗意义。方法选择符合美国国立卫生研究院(NIH)诊断标准的Ⅱ型前列腺炎和Ⅲ型前列腺炎患者67例。常规前列腺液镜检和细菌、支原体、衣原体检查,并对前列腺液中的16s rDNA进行PCR检测,治疗全部采用以抗生素为主的综合治疗。以慢性前列腺炎症状指数(NIH-CPSI)为疗效指标,治疗4周后进行疗效比较。结果Ⅱ、ⅢA和ⅢB型前列腺炎16s rDNA阳性率分别为100%(11/11)、62.5%(20/32)、66.7%(16/24)。Ⅱ型前列腺炎治疗显效率100%;在Ⅲ型前列腺炎中,ⅢA、ⅢB组无差异,而16s rDNA阳性组治疗总显效率(80.0%)明显高于16s rDNA阴性组(52.4%)(P<0.05)。结论前列腺液16s rDNA表达与前列腺炎的疗效有良好的相关性,可作为Ⅲ型前列腺炎选用抗生素治疗的依据,并对前列腺炎分型有一定参考价值。

Objective This study was designed to evaluate the significance of universal 16s rDNA detection in EPS for clinical diagnosis and therapy of patients with chronic prostatitis. Methods 67 patients who accorded with the demands of chronic type Ⅱ and Ⅲprostatitis of National Institute of Health （NIH） underwent a routine urological evaluation, including microscopic examination of EPS, bacteria culture, mycoplasma culture and chlamydiosis culture, followed by combined therapy principally with antibiotics. Then PCR detection of 16s rDNA in EPS was carried out. The NIH Chronic Prostatitis Symptom Index （NIH-CPSI） was performed at the start and the end of 4 weeks＇ therapy to evaluate therapeutic effect. Results The assay suggested that the positive expression rates of 16s rDNA in EPS were respectively 100% （11/11）, 62.5% （20/32） and 66.7% （16/24） in group Ⅱ, ⅢA and Ⅲ B. The ratio with excellent effect in type Ⅲ prostatitis with positive 16s rDNA expression was significantly higher than in the group with negative 16s rDNA expression using the antibiotic therapy strategy （P〈0. 05）, 80.0% versus 52.4%. Conclusion 16s rDNA expression in EPS seems to be related with the therapeutic effect of chronic prostatitis. The 16s rDNA detection might benefit the choice of antibiotics in clinical therapy for type Ⅲ prostatitis, and improve the classification of prostatitis.