良性前列腺增生患者的血清FIB、IL-6表达及其与尿动力学参数的相关性研究

Study on expression of serum FIB,IL-6 and their correlation with urodynamic parameters in patients with benign prostatic hyperplasia

目的观察良性前列腺增生(BPH)患者的血清纤维蛋白原(FIB)、白细胞介素-6(IL-6)表达水平并分析二者与尿动力学参数的关系。方法选择2019年8月至2021年8月成都市新都区人民医院收治的120例BPH患者作为观察组,另选取60例慢性前列腺炎(CP)患者作为对照组;依据国际控尿协会(ICS)建议的Schafer分级将BPH患者分为无梗阻组(25例)、可疑梗阻组(32例)与梗阻组(63例);设计患者基线资料调查表,比较观察组与对照组患者、不同梗阻程度患者的基线资料和实验室指标;分析血清FIB、IL-6在BPH患者中的表达水平及其与患者尿动力学参数的关系。结果观察组的急性尿潴留占比、最大逼尿肌压(Pdetmax)、残余尿量(PVR)、FIB、IL-6均高于对照组,最大尿流率(Qmax)低于对照组,差异均有统计学意义(均P<0.001);梗阻组患者的急性尿潴留占比最高,其次为可疑梗阻组,无梗阻组最低,差异均有统计学意义(均P<0.05);三组间的年龄、体质量指数、合并糖尿病占比、合并高血压战比、合并高脂血症占比及病程比较,差异均无统计学意义(均P>0.05)。梗阻组患者的Pdetmax、PVR及血清FIB、IL-6最高,其次为可疑梗阻组,无梗阻组最低,差异均有统计学意义(均P<0.001);梗阻组患者的Qmax最低,其次为可疑梗阻组,无梗阻组最高,差异均有统计学意义(均P<0.001);经Pearson双变量相关性检验,结果显示,血清FIB、IL-6表达分别与BPH患者Pdetmax、PVR呈正相关(r>0,均P<0.05),与BPH患者Qmax呈负相关(r<0,P<0.05);以净收益率为纵坐标,高风险阈值为横坐标,绘制决策曲线,结果显示,血清FIB、IL-6联合评估BPH患者膀胱出口可疑梗阻、梗阻的净收益率优于二者单独的净收益率;且在高风险阈值0~1.0范围内,血清FIB、IL-6单独及联合评估BPH患者膀胱出口可疑梗阻、梗阻的净收益率均始终>0,有临床意义。经有序回归分析结果显示,血清FIB、IL-6高表达是影响BPH患者膀胱出口梗阻的危险因素(OR>1,均P<0.05)。结论BPH患者血清FIB、IL-6呈异常表达,且二者与患者尿动力学参数有关。

Objective To observe the expression of serum fibrinogen(FIB)and interleukin-6(IL-6)in patients with benign prostatic hyperplasia(BPH),and to analyze the relationship between them and urodynamic parameters.Methods From August 2019 to August 2021,120 patients with BPH treated in the hospital were selected as the observation group,another 60 patients with chronic prostatitis(CP)were selected as the control group,according to the Schafer classification recommended by International Continence Society(ICS),the patients were divided into no obstruction group(25 cases),suspected obstruction group(32 cases)and obstruction group(63 cases).The baseline data questionnaire of patients were designed,the baseline data and laboratory indexes of patients in the observation group and the control group and patients with different degrees of obstruction were compared.The expression of serum FIB and IL-6 in patients with BPH and their relationship with urodynamic parameters were mainly analyzed.Results The proportion of acute urinary retention,maximum detrusor muscle pressure(Pdetmax),residual urine volume(PVR),FIB and IL-6 in observation group were higher than those in control group,and the maximum urinary flow rate(Qmax)in observation group was lower than that in control group,with statistical significance(all P<0.001).The proportion of acute urinary retention in obstruction group was the highest,followed by suspected obstruction group,and the lowest in non-obstruction group,with statistical significance(all P<0.05).Pdetmax,PVR,serum FIB,IL-6 were the highest in obstruction group,followed by suspected obstruction group,and the lowest in non-obstruction group,with statistical significance(all P<0.001).Qmax was the lowest in the obstruction group,followed by the suspected obstruction group,and the highest in the non-obstruction group,with statistical significance(all P<0.001).By the Pearson bivariate correlation test,the results showed that the serum FIB,IL-6 express respectively with BPH patients Pdetmax,PVR were positively correlated(r>0,P<0.05),patients with BPH Qmax negatively correlated(r<0,P<0.05).The decision curve was drawn with the net rate of return as the vertical coordinate and the high risk threshold as the horizontal coordinate.The results showed that the net rate of return in the combined assessment of serum FIB and IL-6 for suspected obstruction of bladder outlet in BPH patients was better than the net rate of return of the two alone.Moreover,in the range of high risk threshold 0-1.0,the net return rate of suspected bladder outlet obstruction and obstruction in BPH patients assessed by serum FIB and IL-6 alone and in combination was always>0,which has clinical significance.The results of orderly regression analysis showed that high levels of serum FIB and IL-6 were risk factors for bladder outlet obstruction in BPH patients(OR>1,all P<0.05).Conclusions Aerum FIB and IL-6 are abnormally expressed in patients with BPH,and they are related to urodynamic parameters.