Ⅰ～Ⅲ型前列腺炎治疗前后PSA变化研究

Changes of PSA before and after treatment of typeⅠ～ Ⅲ prostatitis

目的观察Ⅰ~Ⅲ型前列腺炎治疗前后血清前列腺特异性抗原(PSA)的变化,初步探讨血清PSA在急慢性前列腺炎病情演变中的规律。方法收集2016年9月~2017年12月在潍坊医学院附属医院就诊的167例前列腺炎受试者,采用前瞻性研究。将受试者按不同的前列腺炎类型分为3组:急性细菌性前列腺炎(ABP)组(a组,n=56例)、慢性细菌性前列腺炎(CBP)组(b组,n=57例)、慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)组(c组,n=54例),分别测定抗炎治疗前、抗炎治疗后4周、抗炎治疗后8周血清总前列腺特异性抗原(TPSA)、游离前列腺特异性抗原(FPSA)和FPSA/TPSA的水平,同时c组在治疗前后填写慢性前列腺炎症状指数评分(NIH-CPSI)问卷,分析治疗前后各型前列腺炎血清PSA水平、CP/CPPS治疗前后血清PSA相关值及CPSI评分的变化。结果a组、b组受试者治疗4周后与治疗前、治疗8周后与治疗4周后血清PSA水平比较,差异均有统计学意义(P<0.05)。c组受试者治疗4周后与治疗前血清PSA水平比较,差异有统计学意义(P<0.05);治疗8周后与治疗4周后血清PSA水平比较,差异无统计学意义(P>0.05);受试者血清PSA变化与CPSI评分呈正相关关系(r=0.412)。结论血清PSA不但可作为前列腺癌(PCa)的筛选标志物,也有望作为I型、Ⅱ型、Ⅲ型前列腺炎病变及治疗恢复情况的判断指标之一。CP/CPPS抗炎治疗后,血清PSA变化与CPSI评分呈正相关关系。

Objective To compare and analyze the changes of PSA before and after treatment of typeⅠ-Ⅲprostatitis and to study the regularity of serum PSA in the development of acute and chronic prostatitis preliminarily. Methods A total of 167 subjects with prostatitis from September 2016 to December 2017 in the Affiliated Hospital of Weifang Medical University were collected. Prospective study was adopted. The subjects were divided into three groups according to different types of prostatitis： acute bacterial prostatitis（ ABP） group（ group a,n = 56）,chronic bacterial prostatitis（ CBP）group（ group b,n = 57） and chronic prostatitis/chronic pelvic pain syndrome（ CP/CPPS） group（ group c,n = 54）,Serum total prostate specific antigen（ TPA） and free prostate specific antigen（ FPSA/TPSA） were measured before anti-inflammatory therapy,4 weeks after anti-inflammatory therapy and 8 weeks after anti-inflammatory therapy respectively. Group C were completed NIH-CPSI questionnaire before and after treatment. And the changes of serum PSA before and after treatment of prostatitis and the changes of PSA and CPSI before and after CP/CPPS treatment were analyzed. Results The serum PSA levels in group A were significantly higher than those in group B before and after 4 weeks,after 4 weeks and after 8 weeks,respectively（ P〈0. 05）,and the levels of serum PSA in group C were significantly higher than those in group C（ P〈0.05）. There were significant differences in serum PSA levels between the subjects before and after 4 weeks of treatment（ P〈0. 05）,but there was no significant difference between the changes of serum PSA after 4 weeks and 8 weeks after treatment（ P〉0. 05）,and there was a positive correlation between the changes of serum PSA and CPSI scores. Conclusions The serum PSA is not only a screening marker for prostatic cancer（ PCa）,but also an index for judging the pathological changes of type I,type Ⅱand type Ⅲ prostatitis and the recovery of treatment. There is a positive correlation between the changes of serum PSA and CPSI score after anti-inflammatory therapy with CP/CPPS.