经会阴前列腺穿刺组织的细菌16SrRNA基因检测

Detection of bacterial signal of 16S rRNA gene in prostate tissues obtained by perineal approach from patient with chronic pelvic pain syndrome

目的探讨Ⅲ型前列腺炎（CPPS）的细菌学病因及16SrRNA基因检测对抗生素疗效的预测价值。方法对112例CPPS患者（年龄20～48岁），经会阴前列腺穿刺取得皮下组织及前列腺组织，用聚合酶链反应法（PCR）检测细菌16SrRNA基因。加替沙星片治疗4周后随访，根据治疗前后慢性前列腺炎症状评分（NIH—CPSI）评定疗效。结果18例病人因皮下组织中检测到细菌信号疑为污染而排除，94例完成研究。16SrRNA基因总阳性率63．8％（60／94），Ⅲa型信号阳性率为68．3％（28／41），Ⅲb型60．3％（32／53）。抗生素治疗后16SrRNA基因阳性组总有效率优于阴性组（55．0％比14．7％，P〈0．001），在分组研究中，Ⅲa型和Ⅲb型阳性组有效率均优于阴性组（75％比23．1％，P〈0．001；37．5％比9．5％，P〈0．05）。结论部分CPPS与细菌感染有关，前列腺组织16SrRNA基因检测对抗生素治疗有指导意义。

Objective To explore the role of bacteria in etiology of chronic pelvic pain syndrome （CPPS） , i. e. , chronic prostatitis and the correlation between presence of bacterial signal of 16S ribosomal RNA （ 16S rRNA） gene and the response to antibiotics. Methods Samples of prostatic and subcutaneous tissues were obtained by biopsy via perineal approach from 112 CPPS patients, aged 20 -48. Polymerase chain reaction was conducted to detect the 16S rRNA gene of bacteria. The patients were treated with gatifloxacin 0. 4 g once a day for 4 weeks and then 4 weeks later the effects of treatment were assessed by the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI）. Results PCR was completed in 94 of the 112 patients, and 18 were excluded because their subcutaneous biopsies were positive for 16S rRNA, showing the possible contamination of their prostatic tissues. The total positive rate of bacterial 16S rRNA gene was 63.8% （60/94）. The positive rate of bacterial 16S rRNA gene in the patients with Ⅲa CPPS and Ⅲb CPPS were 68. 3% and 60. 3% respectively. The total gatifloxacin effective rate of positive bacterial signal group after the was 55.0%, significantly higher than that of the negative bacterial signal group（ 14. 7%, P 〈0. 001 ）. The gatifloxacin effective rate of the 16S rRNA positive Ⅲa CPPS patients was 75%, significantly higher than that of the 6S rRNA negative Ⅲa CPPS patients （23. 1%, P 〈 0. 001）, and the gatifloxacin effective rate of the 16S rRNA positive Ⅲb CPPS patients was 37.5%, significantly higher than that of the 6S rRNA negative Ⅲb CPPS patients （9.5% , P 〈0. 05）. Conclusion Bacterial infection is related to CPPS in part of the patients. Bacterial signal detection helps predict the effect of antimicrobial therapy.