术前血清前列腺特异性抗原对前列腺电切手术疗效的影响  

The effect of preoperative serum prostate specific antigen on the efficacy of transurethral resection of prostate

作　　者：郭中强[1] 陈松[1] 熊晶 龚侃[2] 贺大林[3] 刘孝华 陈洪波 却辉 郑江[7] 宋洪飞 姚启盛[9] 耿杰[10] 周治军 祝子清 张景宇 刘涛 石洪波 阮建中 杜丹[17] 任选义 李晓东 窦中岭[20] 曾宪涛 刘同族[1] 王行环[1,21] GUO Zhong-qiang;CHEN Song;XIONG Jing;GONG Kan;HE Da-lin;LIU Xiao-hua;CHEN Hongbo;QUE Hui;ZHENG Jiang;SONG Hong-fei;YAO Qi-sheng;GENG Jie;ZHOU Zhi-jun;ZHU Ziqing;ZHANG Jing-yu;LIU Tao;SHI Hong-bo;RUAN Jian-zhong;DU Dan;REN Xuan-yi;LI Xiao-dong;DOU Zhong-ling;ZENG Xian-tao;LIU Tong-zu;WANG Xing-huan(Department of Urology,Zhongnan Hospital of Wuhan University,Wuhan 430071;Department of Urology,First Hospitalof Peking University,Beijing 100034;Department of Urology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Urology,Minda Hospital Affiliated to Hubei University for Nationalities,Enshi 445000;Department of Urology,The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445099;Department of Urology,Huanggang Central Hospital,Huanggang 438000;Department of Urology,First Peopled Hospital of Jingzhou,Jingzhou 434000;Department of Urology,Qianjiang Central Hospital,Qianjiang 433100;Department of Urology,Shiyan Taihe Hospital,Shiyan 442008;Department of Urology,Central Hospital of Suizhou,Suizhou 441300;Department of Urology,First People's Hospital of Tianmen,Tianmen 431700;Department of Urology,CR S-WISCO General Hospital,Wuhan 430080;Department of Urology,Third Hospital of Wuhan,430060;Department of Urology,The Sixth Hospital of Wuhan,Wuhan 430015;Department of Urology,Xiangyang Central Hospital,Xiangyang 441021;Department of Urology,First Peopled Hospital of Xiaogan,Xiaogan 432100;Department of Urology,Second People's Hospital of Yichang,Yichang 443000;Department of Urology,Central Hospital of Kaifeng,Kaifeng 475099;Department of Urology,Huaihe Hospital of Henan University,Kaifeng 475000;Department of Urology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000;Center for Evidence-Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院泌尿外科,湖北武汉430071 [2]北京大学第一医院泌尿外科,北京100034 [3]西安交通大学第一附属医院泌尿外科,陕西西安710061 [4]湖北民族学院附属民大医院泌尿外科,湖北恩施445000 [5]恩施土家族苗族自治州中心医院泌尿外科,湖北恩施445099 [6]黄冈市中心医院泌尿外科,湖北黄冈438000 [7]荆州市第一人民医院泌尿外科,湖北荆州434000 [8]长江大学附属潜江市中心医院泌尿外科,湖北潜江433100 [9]十堰市太和医院泌尿外科,湖北十堰442008 [10]湖北医药学院附属随州市中心医院泌尿外科,湖北随州441300 [11]湖北科技学院附属医院(天门市第一人民医院)泌尿外科,湖北天门431700 [12]华润武钢总医泌尿外科,湖北武汉430080 [13]武汉大学同仁医院(武汉市第三医院)泌尿外科,湖北武汉430060 [14]江汉大学附属医院(武汉市第六医院)泌尿外科,湖北武汉430015 [15]湖北文理学院附属医院(襄阳市中心医院)泌尿外科,湖北襄阳441021 [16]孝感市第一人民医院泌尿外科,湖北孝感432100 [17]三峡大学第二人民医院(宜昌市第二人民医院)泌尿外科,湖北宜昌443000 [18]开封市中心医院泌尿外科,河南开封475099 [19]河南大学淮河医院泌尿外科,河南开封475000 [20]河南科技大学第一附属医院泌尿外科,河南洛阳471000 [21]武汉大学中南医院循证与转化医学中心,湖北武汉430071

出　　处：《现代泌尿外科杂志》2019年第11期902-905,共4页Journal of Modern Urology

基　　金：国家重点研发计划项目（No.2016YFC0106300）;国家自然科学基金项目（No.81702513）

摘　　要：目的探讨术前血清前列腺特异性抗原(PSA)对经尿道前列腺等离子双极电切术(TUPKP)患者疗效的影响。方法根据术前血清PSA水平,将国内20家医院收治的774例行TUPKP治疗的良性前列腺增生(BPH)患者分为两组,PSA>3.3ng/mL组485例,PSA≤3.3ng/mL组289例,术前比较两组患者的年龄、前列腺体积、生活质量评分(QoL)、最大尿流率、残余尿量、国际前列腺症状评分(IPSS);术后比较血红蛋白(Hb)变化、膀胱冲洗时间、尿管留置时间、住院天数;术后3个月比较最大尿流率、残余尿量、IPSS评分、QoL评分等临床指标。结果 PSA>3.3ng/mL组年龄、前列腺体积、术前QoL评分、术后Hb变化均显著>PSA≤3.3ng/mL组(P<0.05);而术前最大尿流率显著小于PSA≤3.3ng/mL组(P<0.05)。术后3个月随访结果表明:PSA>3.3ng/mL组术后残余尿量、IPSS评分显著小于PSA≤3.3ng/mL组(P<0.05)。结论术前血清PSA可作为行TUPKP的BPH患者的疗效预测因子,PSA水平越高手术效果越佳。Objective To explore the effect of preoperative serum prostate specific antigen(PSA)on the efficacy of transurethral bipolar plasma kinetic prostatectomy(TUPKP).Methods According to preoperative serum PSA level,774 patients with benign prostate hyperplasia(BPH)from20 hospitals treated with TUPKP were divided into 2 groups:485 patients in PSA>3.3 ng/mL group and 289 patients in PSA<3.3 ng/mL group.Before operation,the patients’age,prostate volume,quality of life(QoL)score,maximum flow rate,residual urine volume,and I-PSS score were compared between the two groups.After operation,hemoglobin(Hb)changes,bladder irrigation time,indwelling time of urinary catheter,hospitalization days,and the 3-month maximum flow rate,residual urine volume,I-PSS score and QoL score were compared.Results The age,prostate volume,preoperative QoL score and postoperative Hb changes were significantly greater in PSA>3.3 ng/mL group than in PSA<3.3 ng/mL group(P<0.05).The preoperative maximum flow rate was significantly lower in PSA>3.3 ng/mL group(P<0.05).Three months after operation,the residual urine volume and I-PSS score were significantly lower in PSA>3.3 ng/mL group(P<0.05).Conclusion Preoperative serum PSA level can be used to predict the therapeutic effect of TUPKP.BPH patients with higher PSA level may have better clinical outcomes.

关 键 词：良性前列腺增生 前列腺特异性抗原 经尿道前列腺等离子双极电切术 预测因子 疗效 

分 类 号：R697.32[医药卫生—泌尿科学]