前列腺增生症患者C反应蛋白与下尿路症状关系的临床研究

Correlation between serum C-reactive protein level and lower urinary tract symptoms in men with benign prostatic hyperplasia

目的探讨前列腺增生患者血C反应蛋白(CRP)与下尿路症状的关系。方法共141例在我院就诊的前列腺增生并有下尿路症状患者,所有患者行IPSS评分、体格检查、最大尿流率测定、尿量、残余尿、前列腺体积、血PSA和CRP测定。计算排尿期评分(IPSS-V)与储尿期评分(IPSS-S)的比值(用IPSS-V/S表示),当IPSS-V/S≥1时给予患者α-受体阻断剂口服,当IPSS-V/S<1时给予患者抗毒蕈碱剂口服。比较血CRP水平与各参数之间的关系及服药后各参数的变化。结果所有患者平均血CRP值为(3.43±2.30)mg/L,单因素相关分析提示血CRP与年龄、PSA、排尿量相关,与残余尿、前列腺体积无关,与总IPSS、IPSS-S正相关,与IPSS-V/S负相关。多因素分析血CRP与年龄、总IPSS和IPSS-S相关。IPSS-V/S<1患者给予托特罗定治疗3月后血CRP明显下降。结论前列腺增生患者血CRP与储尿期症状及膀胱功能障碍相关,表明慢性炎症是储尿期症状为主的下尿路症状的原因之一。

Objective To investigate the association between serum C‐reactive protein （CRP） level in men with benign prostatic hyperplasia （BPH） and lower urinary tract symptoms （LUTS） .Methods A total of 141 men with BPH and LUTS were enrolled .All patients completed the International Prostate Symptoms Score （IPSS） and urological examinations .The pa‐rameters of maximum flow rate （Qmax） ,voided volume ,post‐void residual ,prostate volume ,serum prostate specific antigen （PSA） and serum CRP levels were obtained .All patients were treated with alpha‐blocker or antimuscarinic agent based on the IPSS voiding to storage subscore ratio （IPSS‐V/S） .Correlation analyses were performed between serum CRP levels with age , IPSS ,TPV ,Qmax ,PVR ,VV ,PSA and between baseline and post treatment .Results The mean serum CRP level was （3.43 ± 2 .30）mg/L .Univariate analyses revealed serum CRP levels were significantly associated with age （P〈0 .001） ,PSA levels （P〈0 .05） and voided volume （P〈0 .05） ,but not with post‐void residual or prostate volume （P〉0 .05） .CRP levels were positively associated with total IPSS （P〈0 .05） and storage IPSS （P〈0 .001） ,and negatively associated with IPSS‐V/S （ P〈0.001） .Multivariate analyses revealed that serum CRP levels were significantly associated with age （P〈0 .05） ,total IPSS and storage IPSS subscore （P〈0 .001） .Patients with IPSS‐V/S〈1 and treated with tolterodine for 3 months had significant decrease of CRP levels after treatment .Conclusion Serum CRP levels are associated with storage LUTS and sensory bladder disorders ,suggesting chronic inflammation might play a role in patients with storage predominant LUTS .