血清游离前列腺特异性抗原对良性前列腺增生患者预后的评估价值探讨

Value of serum free prostate specific antigen in predicting prognosis in patients with benign prostatic hyperplasia

目的探讨良性前列腺增生(BPH)患者经尿道前列腺剜除术(TUERP)后血清游离前列腺特异性抗原(fPSA)水平变化及其与前列腺体积、预后的关系。方法将105例行TUERP的BPH患者根据术前的前列腺体积分为小体积组(n=49)、中体积组(n=36)和大体积组(n=20)。比较3组患者术前及术后1、3、7 d时血清fPSA水平。Pearson法分析术前血清fPSA水平与前列腺体积的关系。比较不同预后BPH患者临床资料及术后7 d血清fPSA水平。采用Logistic回归分析探讨BPH患者不良预后的影响因素。结果术前及术后1 d时,小体积组、中体积组、大体积组患者血清fPSA水平呈增高趋势,组间比较差异均有统计学意义(P<0.05)。Pearson法分析结果显示,BPH患者术前血清fPSA水平与前列腺体积呈正相关(r=0.598,P<0.05)。与预后良好组(n=79)相比,预后不良组(n=26)高密度脂蛋白胆固醇(HDL-C)、血糖、术后7 d血清fPSA水平及合并高血压比率均升高,差异有统计学意义(P<0.05)。Logistic回归分析,结果显示HDL-C、血糖、合并高血压、术后7 d血清fPSA均为BPH患者预后的危险因素(P<0.05)。结论BPH患者血清fPSA呈高水平表现,其可能参与影响BPH发病过程。术后7 d血清fPSA水平可评估BPH患者TUERP后的预后情况。

Objective To investigate the change of serum free prostate specific antigen(fPSA)in patients with benign prostatic hyperplasia(BPH)after transurethral enucleative resection of prostate(TUERP)and its relationships with prostate volume and prognosis.Methods A total of 105 BPH patients with TUERP were divided into small volume group(n=49),medium volume group(n=36)and large volume group(n=20)according to preoperative prostate volume.The levels of serum fPSA were compared among three groups before operation and 1 day,3 and 7 days after operation.The relationship between preoperative serum fPSA level and prostate volume was analyzed by Pearson method.The clinical materials and the level of serum fPSA at 7 days after operation were compared among BPH patients with different prognosis.Logistic regression analysis was used to explore the influencing factors of poor prognosis in BPH patients.Results Before operation and 1 day after operation,the levels of serum fP SA in the small volume group,the medium volume group and the large volume group increased significantly(P<0.05).Pearson analysis showed that there was a positive correlation between preoperative serum fP SA level and prostate volume in patients with BPH(r=0.598,P<0.05).Compared with the good prognosis group(n=79),the high density lipoprotein cholesterol(HDL-C),blood glucose,serum fP SA level at 7 days after operation and the ratio of cases with hypertension in the poor prognosis group(n=26)were significantly higher(P<0.05).Logistic regression analysis showed that HDL-C,blood glucose,hypertension and serum fP SA at 7 days after operation were the risk factors for the prognosis of BPH patients(P<0.05).Conclusion The serum fP SA level is highly expressed in BPH patients,which may be involved in the pathogenesis of BPH.The serum fP SA level at 7 days after operation can be used to evaluate the prognosis of BPH patients after TUERP.