过敏毒素C3a与前列腺增生症合并组织炎症的关系  

The Relationship between Anaphylatoxin C3a and Benign Prostatic Hyperplasia with Inflammation

作　　者：谢亮[1,2] 程树林[3] 李一竹[1] 柳良仁[1] 韩平[1] 陈妮[4] 魏强[1] 周桥[4] 

机构地区：[1]四川大学华西医院泌尿外科,成都610041 [2]川北医学院附属医院普外科 [3]川北医学院附属医院泌尿外科,南充637000 [4]四川大学华西医院病理科,成都610041

出　　处：《四川大学学报（医学版）》2011年第5期642-645,共4页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(批准号30772171)资助

摘　　要：目的研究前列腺按摩液(expressed prostatic secretions,EPS)中过敏毒素C3a对良性前列腺增生症(BPH)合并增生前列腺组织炎症的诊断价值,及其与临床病理特征的关系。方法共纳入40例患者,检查血清前列腺特异抗原(PSA)、血清游离前列腺特异性抗原(fPSA)、尿常规、血常规,采用国际前列腺症状评分(IPSS)评估下尿路症状,采用美国国立卫生研究院慢性前列腺炎症指数(NIH-CPSI)评估患者前列腺炎症症状;经直肠B超测前列腺体积。术前采集所有患者的EPS行双抗体夹心ELISA法测定C3a浓度。术中无菌操作取前列腺组织标本作病理炎症分级。另取10例正常年轻人EPS作为对照组。结果增生前列腺组织重度炎症组EPS中C3a浓度较轻度炎症组升高(P<0.01),两组均较对照组升高(P<0.01)。EPS中C3a可用于判断是否合并增生前列腺组织炎症,其灵敏度为0.97,特异度为0.70。EPS中C3a浓度与血清PSA、fPSA含量,患者年龄及体重指数(BMI)没有相关性;但与NIH-CPSI评分有相关性(r=0.495,P<0.01)。前列腺小体积组与大体积组、尿常规WBC异常组与正常组EPS中C3a浓度差异均无统计学意义。保留尿管组与未置尿管组EPS中C3a浓度差异有统计学意义(P<0.05)。结论 C3a用于判断BPH是否合并增生前列腺组织炎症有一定价值。EPS中C3a浓度与NIH-CPSI评分、留置尿管有关,未发现与患者年龄,BMI,血清PSA、fPSA浓度,前列腺体积和尿常规WBC数有关。Objective To study the relationship of anaphylatoxin C3a level in expressed prostatic secretions（EPS） with prostate tissue inflammation in BPH.Methods This study included 40 BPH patients receiving TURP operational therapy in West China Hospital during September,2009 to March,2010.For each patient,IPSS and NIH-CPSI were evaluated,serum PSA levels,prostatic volume and urine WBC were measured.EPS was collected before operation for the test of C3a level,while EPS also was obtained from 10 healthy men as normal control.Prostatic tissue was collected by the operation and histological inflammation was investigated by histopathological study.Results C3a levels in EPS of the BPH patients： severe inflammation groupmild inflammation groupnormal control group（all P0.01）.C3a levels in the EPS could be used to determine whether BPH combined inflammation,sensitivity ：0.97,specificity： 0.70.C3a levels in EPS was not relevant with PSA,fPSA levels,age,BMI,prostate volume or urine WBC levels;but NIH-CPSI was correlated（r=0.495,P0.01）.C3a in EPS of retained catheter group was more than non-catheter group significantly（P0.05）.Conclusion C3a is an ideal criteria to diagnose prostatic histological inflammation in BPH patients.There is no convincing evidence to correlate C3a in EPS with serum PSA levels,BMI,age,prostatic volume and urine＇s WBC.Excessively high C3a levels and the NIH-CPSI,indwelling have correlations.

关 键 词：前列腺增生症 增生前列腺组织炎症 C3A 过敏毒素 

分 类 号：R697[医药卫生—泌尿科学]