经尿道前列腺等离子电切术联合剜除术在前列腺增生症患者中的应用及对MCP-1和PDGF-BB表达的影响研究

The application of transurethral resection of prostate and enucleation in patients with benign prostatic hyperplasia and its effect on MCP-1 and PDGF-BB expression

目的:分析经尿道前列腺等离子电切术联合剜除术治疗前列腺增生的临床疗效及对单核细胞趋化因子-1(MCP-1)、血小板衍生生长因子BB(PDGF-BB)的影响,为临床前列腺增生患者治疗方案的选择提供参考。方法:选择2015年1月至2017年1月华北理工大学附属医院收治的前列腺增生患者86例作为研究对象,根据就诊顺序编号,采用数字随机表法将其分为两组,每组43例。一组采用经尿道前列腺等离子电切术联合剜除术治疗,设为观察组;一组采用经尿道前列腺等离子电切术治疗,设为对照组。比较两组患者术后临床疗效、围术期并发症情况,术前、术后1周采集患者静脉血,采用疫荧光发分析MCP-1、PDGFBB的表达变化。结果:两组患者一般资料比较差异无统计学意义(P>0.05)。术后3个月进行临床疗效评价,观察组(IPSS、尿流率、残余尿)改善效果明显优于对照组,其差异具有统计学意义(P<0.05);比较两组患者术后并发症率,其差异无统计学意义(P>0.05)。比较两组患者术前血清MCP-1、PDGF-BB表达,其差异无统计学意义(P>0.05);术后一周,两组患者血清MCP-1、PDGF-BB均较术前明显降低,其差异具有统计学意义(P<0.05),且观察组MCP-1、PDGF-BB均低于对照组,其差异具有统计学意义(P<0.05)。结论:经尿道前列腺电切术联合剜除术可以有效提高前列腺增生患者的临床疗效,并不增加并发症率,且可以更有效地改善影响患者前列腺平滑肌异常增生的MCP-1、PDGF-BB水平,消除前列腺增生的发病原因。

Objective： To analyze the clinical efficacy of transurethral resection of prostate（ TURP） and enucleation in the treatment of benign prostatic hyperplasia（ BPH） and the effect on monocyte chemoattractant factor-1（ MCP-1）,platelet-derived growth factor-BB（ PDGF-BB）,in order to provide a reference for the treatment of BPH patients. Methods： 86 BPH patients treated in the Hospital Affiliated to North China University of Technology from January 2015 to January 2017 were selected and,according to the order of treatment,were divided into two groups randomly. The control group was treated by TURP,and the observation group was treated with TURP combined with enucleation. The clinical efficacy and perioperative complications of the two groups were compared. The venous blood was collected before and a week after operation. The expression of MCP-1 and PDGF-BB was detected by immunofluorescence. Results： There was no significant difference between the two groups in general information（ P〉0. 05）. Improvements in the IPSS,urinary flow rate and residual urine were significantly better in the observation group than those in the control group（ P〈0. 05）. There was no significant difference in the incidence of postoperative complication between the two groups. There was no significant difference in the expression of MCP-1 and PDGF-BB between the two groups（ P〉0. 05）. The levels of MCP-1 and PDGF-BB in the two groups were significantly lower than those before operation（ P〈0. 05）,and the levels of MCP-1 and PDGF-BB in the observation group were lower than those in the control group（ P〈0. 05）. Conclusions： TURP combined with enucleation can be used to improve the clinical curative effect for BPH and improve the level of MCP-1 and PDGF-BB,without increasing the complication rate,hereby eliminating the causes of BPH.