尿道膜法分型诊断前列腺炎临床分析

Clinical research on classifying Prostatitis by artificial urethra membrane

目的采用尿道膜"一杯法"对慢性前列腺炎进行分型诊断,探讨其诊断准确性,安全性及费用。方法慢性前列腺炎患者180例,随机选择其中60例进行"四杯法"检查;另外120例随机分入"一杯法"试验组(60例)和安慰剂组(60例)进行双盲研究;采集受试者的尿液和前列腺按摩液进行镜检和细菌学检查;同时对患者进行疼痛评分,收集受试者处理前后血液样本行血常规和肝肾功能检查,进行安全性评估;收集"四杯法"和"一杯法"的操作步骤和费用数据;结果 "一杯法"试验组Ⅱ型、ⅢA型和ⅢB型检出率分别为7.14%、48.22%和44.64%,"四杯法"组Ⅱ型、ⅢA型和ⅢB型分别为15.00%、46.67%和38.33%,两组数据比较差异无统计学意义(P>0.05)。"一杯法"安慰剂组Ⅱ型、ⅢA型和ⅢB型诊断准确率分别为43.33%、36.67%和20.00%。"一杯法"试验组、"四杯法"组与"一杯法"安慰剂组Ⅱ型和ⅢB型比较,差异有统计学意义(P<0.05)。"一杯法"两组受试者血常规、肝肾功能均在正常范围内,疼痛评分分别为(2.90±1.29)分和(3.00±1.05)分,差异无统计学意义(P>0.05)。"一杯法"法操作步骤和费用明显少于"四杯法"。结论尿道膜"一杯法"能更准确对慢性前列腺炎进行分型诊断,减少因假阳性而导致的误诊,且操作简化,费用低。

Objective To investigate the accuracy,safety and cost of a new ＂shortcut＂ method for diagnozing chronic prostatitis.Methods A total of 180 patients with chronic prostatitis were enrolled in this study.Of 60 patients were randomly selected for traditional expressed prostatic secretion（EPS）detection;the other 120 cases were randomly divided into the ＂shortcut＂ trial group（n=60）and the placebo group（n=60）,then conducted a double-blind study;the urine and EPS sample for all subjects were collected to perform microscopic examination of white blood cell and bacteriological examination;meanwhile,blood samples before and after treatment were collected and pain score assessement was carried out to evaluate their safety;collecting data about operation steps and costs;the data analysis was performed using SPSS17.0 statistical software and P〈0.05 was thought to be statistically significant.Results Accuracy for diagnosis Compared to the traditional method [Ⅱ（15.00%）,ⅢA（46.67%）and ⅢB（38.33%）],the ＂shortcut＂ method [Ⅱ（7.14%）,ⅢA（48.22%）and ⅢB（44.64%）] has shown slightly more accurate in the diagnosis of chronic prostatitis,but the difference was not statistically significant（P〉0.05）.However,the results from the two former methods were better than that of the placebo group [Ⅱ（43.33%）,ⅢA（36.67%）and ⅢB（20.00%）]（P〈0.05）;Safety assessment There were no differeces in the results of blood routine,liver and kidney check and pain score between trial and placebo group（2.90±1.29 VS 3.00±1.05,P〉0.05）;Comparison of cost Both the steps of ＂shortcut＂ method and its costs were significantly shorten compared to the traditional method.Conclusion The ＂shortcut＂ method may improve accuracy in the diagnosis of chronic prostatitis, reduce the misdiagnosis caused by false positive,and its operation is simplified and the cost is low