小剂量糖皮质激素治疗ⅢA型前列腺炎中前列腺液TNF-α及IL-10的表达变化及意义

Expression Changes and Significance of TNF-α and IL-10 in Prostatic Fluid on Prostatitis Type ⅢA Treatment with Low Dose Glucocorticoid

目的:分析小剂量糖皮质激素治疗ⅢA型前列腺炎的效果及对前列腺液肿瘤坏死因子-α(TNF-α)及白介素-10(IL-10)的表达变化影响。方法:选取2018年1月-2019年11月医院收治的100例ⅢA型前列腺炎患者作为研究对象,按照随机数字表法分为对照组和试验组,对照组50例予以常规治疗,在此基础上试验组予以小剂量糖皮质激素治疗。治疗4周后,比较两组患者临床疗效、美国国立卫生研究院慢性前列腺炎症状指数(National Institutes of Health chronic prostatitis symptom index,NIH-CPSI)评分及治疗前后前列腺液TNF-α、IL-10水平,并分析前列腺液TNF-α及IL-10水平与NIH-CPSI的相关性。结果:治疗4周后,试验组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗4周后,试验组疼痛与不适症状、排尿症状、生活质量及NIH-CPSI总分均明显低于对照组,差异有统计学意义(P<0.05)。治疗4周后,试验组前列腺液TNF-α及IL-10水平均明显低于对照组,差异有统计学意义(P<0.05)。Pearson相关系数法分析结果显示,前列腺液TNF-α及IL-10与NIH-CPSI评分均呈显著正相关性(r>0,P<0.05)。结论:在常规治疗基础上给予小剂量糖皮质激素治疗ⅢA型前列腺炎,可进一步提高疗效,减轻炎症反应程度,明显改善NIH-CPSI评分,且未加重不良反应,值得临床重视。

Objective:To analyze the efficacy of low-dose glucocorticoid in the treatment of type ⅢA prostatitis and its effect on tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) expression in prostatic fluid.Method:A total of 100 patients with type ⅢA prostatitis in our hospital from January 2018 to November 2019 were selected and randomly divided into the control group and the experimental group.50 cases in the control group were given conventional treatment,and on this basis,the experimental group was given low-dose glucocorticoid treatment.After 4 weeks of treatment,the clinical efficacy,National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score and TNF-α in prostatic fluid before and after treatment were compared between the two groups.The correlation of the levels of IL-10,TNF-α in prostatic fluid were analyzed with NIH-CPSI.Result:After 4 weeks of treatment,the total effective rate of the experimental group was significantly higher than that of the control group,the difference was statistically significant (P<0.05).After 4 weeks of treatment,the pain and discomfort symptoms,urination symptoms,quality of life and total NIH-CPSI score of the experimental group were significantly lower than those of the control group,the differences were statistically significant (P<0.05).After 4 weeks of treatment,the TNF-α and IL-10 levels in prostatic fluid of the experimental group were significantly lower than those of the control group,the differences were statistically significant (P<0.05).The results of Pearson correlation coefficient analysis showed that the level of TNF-α and IL-10 in prostatic fluid were positive correlated with NIH-CPSI score (r>0,P<0.05).Conclusion:On the basis of conventional treatment,low-dose glucocorticoid in the treatment of type ⅢA prostatitis can further improve the curative effect,reduce the degree of inflammatory reaction,significantly improve NIH-CPSI,and does not aggravate the adverse reactions,which is worthy of clinical attention.