PSA预测BPH发生急性尿潴留的临床研究

Clinical study of PSA in predicting acute urinary retention in BPH patients

目的：探讨血清前列腺特异性抗原（PSA）预测BPH发生急性尿潴留（AUR）的临床意义。方法：回顾性分析2005年1月-2013年9月收住我院确诊为BPH的患者临床资料,共386例,将其分为尿潴留组与非尿潴留组,应用统计学方法比较两组间之间血清总前列腺特异性抗原（tPSA）、前列腺体积（PV）、前列腺特异性抗原密度（PSAD）是否存在差异,寻找能够准确预测尿潴留的临床指标;应用Sperman’s相关分析,了解变量之间的关系;应用受试者工作特征曲线（ROC曲线）,确定相关指标预测AUR的分界值。结果：尿潴留组中tPSA、PV、PSAD均明显高于非尿潴留组,上述指标在两组患者中存在显著差异;随着tPSA、PV、PSAD的增高,尿潴留的发生率逐渐增加;tPSA、tPSA/年龄、PSAD的ROC曲线下面积大致相同。结论：tPSA、tPSA/年龄、PV、PSAD可作为前列腺增生发生AUR的预测因素,从而对是否对疾病尽早进行有效干预及疾病的预后起着重要的作用。

Objective：To investigate the clinical significance of prostate specific antigen（PSA）in predicting the incidence of acute urinary retention（AUR）in BPH patients.Method：From January 2005 to September 2013 in our hospital,we retrospectively analyzed the clinical data of 386 BPH patients.They were divided into AUR group and non-AUR group.We compared total prostate specific antigen（tPSA）,the ratio of tPSA and age（tPSA/age）,prostate volume（PV）and prostate specific antigen density（PSAD）between two groups and analyzed whether there existed statistical differences in order to find some clinical indicators to predict AUR in BPH patients.We studied the relationship in variables by Sperman’s correlation analysis and identified boundary value from relevant indicators to predict AUR by ROC（receiver operator characteristic）curve.Result：The numerical value of tPSA,PV,PSAD in AUR group were significantly higher than non-AUR group,and there were statistical differences between two groups.With the value of tPSA,PV and PSAD increasing,the incidence of AUR increased gradually.The areas of tPSA,tPSA/age and PSAD under ROC curve were roughly the same.Conclusion：The factors of tPSA,tPSA/age,PV and PSAD may be used to predict AUR in BPH patients,which play an important role in estimating whether the disease should be early effectively intervened so as to improve the prognosis of BPH.