血清PSA对评估前列腺增生症并急性尿潴留后膀胱尿道功能的意义

To evaluate the vesieourethral function an its significance in patient with acute urinary retention secondary to benign prostatic hyperplasia by prostate-specific antigen （PSA）

目的探讨前列腺增生症（BPH）并急性尿潴留（AUR）后血清前列腺特异抗原（PSA）时评估膀胱尿道功能的临床意义。方法对随机选择的36例已留置尿管的BPH并AUR患者进行尿流动力学检查，且同日行血清PSA测定并分为两组，A组16例（≤8ng/ml）和B组20例（〉8ng／m1），分析血清PSA与各因素的相关性。结果36例患者血清总PSA（t-PSA）（11．98±6．15）ng/ml，游离PSA（f-PSA）（2．74±0．64）ng/ml，两者均与前列腺体积、膀胱出口梗阻（BOO）、逼尿肌收缩力有相关性（r分别为0．327、0．469，0.272、0．336，0．414、0．419，P值分别为〈0．01、0．01，0．05、0．01，0．01、0．01），f／tPSA与前列腺体积有相关性（r=0．231，P〈0．05），而与BOO、逼尿肌收缩力均无相关性。逼尿肌收缩力受损在A组中占81．3％（13／16），B组中占30％（6／20）。结论对已留置尿管2d以上的BPH并AUR患者，血清PSA高低可间接反映患者逼尿肌收缩力强弱，PSA≤8ng／ml者，其收缩力受损可能性大。

Objective To evaluate the vesicourethral function in patients with acute urinary retention （ AUR ） secondary to benign prostatic hyperplasia （ BPH ） and its clinical significance by prostate- specific antigen （ PSA ）.Methods A total of 36 patients with AUR secondary to BPH who underwent catheterization were selected randomly and underwent urodynamic study.Blood samples for serum PSA measurement were obtained in time and divided into 2 groups：A group was 16 cases（ PSA ≤ 8 ng/ml ）and B group was 20 cases（ PSA 〉 8 ng/ml ）.The correlations were analyzed among serum PSA and many factors. Results Among 36 patients, total PSA was （ 11.98 ±6.15 ） ng/ml, and free PSA was （ 2.74 ±0.64 ） ng/ml, these two factors were correlated with prostate volume （ PV ）, bladder outlet obstruction （ BOO ）, detrusorcontractility （r=0.327/0.46, 0.272/0.336, 0.414/0.419, respectively; P〈 0.01/0.0, 0.05/0, 01,0.01/0.01, respectively ）.NO correlation among f/tPSA , BOO and detrusor contractility were indicated , but the correlation between f/tPSA and PV was found （ r=0.231, P 〈 0.05 ）.The contractility of detrusor muscle in A group were weaker in 81.3% （ 13/16 ）, while 30% （ 6/20 ） in B group.Conclusions The level of of serum PSA could indirectly indicate the stronger or weaker contractility of detrusor muscle in patients underwent catheterization who presented AUR secondary to BPH. Contractility was possible weaker when PSA ≤ 8ng/ml.