血清C反应蛋白预测老年前列腺增生症患者发生急性尿潴留的临床价值

Clinical value of C-reactive protein to predict the occurrence of acute urinary retention in elderly patients with benign prostatic hyperplasia

目的探讨前列腺增生患者血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)预测其发生急性尿潴留的临床价值。方法确诊前列腺增生的门诊患者,首次确诊即测量血清hs-CRP和前列腺特异性抗原(prostate specific antigen,PSA)水平,并行国际前列腺症状(international prostate symptom score,IPSS)、前列腺体积(prostate volume,PV)、最大尿流率(maximum urinary flow rate,Qmax)检测。随访1年,比较发生尿潴留患者和未发生尿潴留患者血清hs-CRP水平以及2组各观察指标之间的差异。采用Logistic回归分析影响急性尿潴留发生的相关因素,采用受试者人工特征(ROC)曲线分析各指标预测尿潴留的能力。结果 830例患者纳入此项研究。随访1年内,共有52例患者发生急性尿潴留,尿潴留患者血清hs-CRP平均值为(3.26±1.35)mg/L,未发生尿潴留患者血清hs-CRP平均值为(1.21±0.46)mg/L,差异有统计学意义(P<0.05)。Logistic回归显示,hs-CRP、IPSS评分、Qmax、PV对预测急性尿潴留均有统计学意义,ROC曲线分析显示血清hs-CRP水平预测急性尿潴留的临床价值高于Qmax、PV(P<0.05)。结论前列腺增生患者血清hs-CRP可作为预测发生急性尿潴留的指标之一,联合应用hs-CRP、IPSS评分、Qmax、PV可以提高预测尿潴留发生的准确率。

Objective To discusse the clinical value of high-sensitivity C-reactive protein（ hs-CRP） to predict the occurrence of acute urinary retention in elderly patients with benign prostatic hyperplasia. Methods Outpatients diagnosed with benign prostatic hyperplasia were selected. Serum levels of hs-CRP and prostate specific antigen（ PSA） at first diagnosis were measured,and International Prostate Symptom Score（ IPSS） was assessed,the prostate volume（ PV）and maximum flow rate（ Qmax） were measured and calculated. The differences in serum hs-CRP levels and other parameters between urinary retention patients and non-urinary retention patients were analyzed. Results A total of 830 patients were included in this study. In 1 year follow-up,a total of 52 patients suffered from acute urinary retention. The serum level of hs-CRP in urinary retention patients（ 3. 26 ± 1. 35 mg / L） was statistically higher than that in non-urinary retention patients（ 1. 21±0. 46 mg / L）（ P〈0. 05）. Binary Logistic regression analysis showed that hs-CRP,IPSS,Qmax,PV could predicted acute urinary retention,and ROC curve analysis showed that the clinical value of serum hs-CRP was higher than Qmax,PV（ P〈0. 05）. Conclusions The serum level of hs-CRP may be used as one of the indicators to predict the occurrence of acute urinary retention for patients with benign prostatic hyperplasia. Combining hs-CRP,IPSS score,Qmax,PV can improve the accuracy of prediction for urinary retention.