不同前列腺炎患者前列腺液标本CRP、Zn及WBC的联合诊断价值

Value of combined diagnosis of prostatic fluid CRP,Zn and WBC for prostatitis

目的探讨前列腺液C反应蛋白(CRP)、锌(Zn)及白细胞计数(WBC)对前列腺炎的鉴别诊断价值。方法采取个体匹配病例对照的研究方式,以40例慢性细菌性前列腺炎患者为研究组A,按照1∶4配比选取160例慢性无菌性前列腺炎患者作为研究组B,并选择40例体检健康人群作为对照组。收集所有研究对象的前列腺液标本,分析其CRP、Zn、WBC水平,绘制受试者工作特征曲线(ROC曲线),分析3种指标单独检测及联合检测对慢性细菌性前列腺炎、慢性无菌性前列腺炎的诊断效能。结果3组不同炎症指标比较,研究组A的CRP、WBC水平[(6.19±0.97)mg/L、(18.81±4.25)个/高倍视野(HP)]显著高于研究组B[(5.60±0.97)mg/L、(14.62±3.12)个/HP]和对照组[(2.07±0.45)mg/L、(5.91±1.03)个/HP],差异均有统计学意义(P<0.05);研究组A的Zn水平[(209.65±96.81)μmol/L]显著低于研究组B[(431.44±98.34)μmol/L]、对照组[(515.85±83.57)μmol/L],差异有统计学意义(P<0.05)。诊断慢性细菌性前列腺炎的ROC曲线中,CRP、Zn和WBC的曲线下面积依次为0.682、0.754和0.792,且联合检测时曲线下面积为0.867。结论前列腺炎患者可出现前列腺液CRP、WBC、Zn水平变化,以CRP的鉴别诊断效能较佳,但多种指标联合检测可有效诊断及鉴别不同类型前列腺炎。

Objective To investigate the value of prostatic fluid C reactive protein(CRP),zinc(Zn)and white cell count(WBC)for differential diagnosis of prostatitis.Methods In the case-control study,40 patients with chronic bacterial prostatitis were selected as study group A,160 patients with chronic aseptic prostatitis were selected as study group B according to the ratio of 1∶4,and 40 healthy people were enrolled as control group.The level of CRP,Zn and WBC in prostatic fluid samples were detected.The receiver operator characteristic curve(ROC curve)were established to judge diagnostic value of CRP,Zn and WBC in the diagnosis of chronic bacterial prostatitis and aseptic chronic prostatitis.Results The level of CRP and WBC in study group A[(6.19±0.97)mg/L,(18.81±4.25)/high magnification(HP)]were significantly higher than those in study group B[(5.60±0.97)mg/L,(14.62±3.12)/HP]and control group A[(2.07±0.45)mg/L,(5.91±1.03)/HP](P<0.05).The level of Zn in study group A[(209.65±96.81)mol/L]was significantly lower than that in study group B[(431.44±98.34)mol/L]and control group[(515.85±83.57)mol/L](P<0.05).Among the ROC curves for diagnosis chronic bacterial prostatitis,the area under the ROC curves of CRP,Zn and WBC were 0.682,0.754 and 0.792,respectively,while it was 0.867 when combined detection.Conclusion There may be changes in prostatic fluid CRP,WBC and Zn levels in patients with prostatitis,among which the differential diagnosis efficiency of CRP is the best,but multiple indicators combined detection can effectively diagnose and differentiate different types of prostatitis.