血清tPSA和PGE2水平对良性前列腺增生患者前列腺剜除术后疗效的预测价值  

Predictive value of the curative effect after prostate enucleation by levels of serum total prostate specific antigen and prostaglandin E2 in patients with benign prostatic hyperplasia

作　　者：郑伟 南涛 李永强 宫小勇[2] 王珂 ZHENG Wei;NAN Tao;LI Yongqiang;GONG Xiaoyong;WANG Ke(Department of Urology,Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,China;Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,China;Department of Urology,Xianyang First People′s Hospital,Xianyang 712000,Shaanxi,China)

机构地区：[1]陕西省中医药大学第二附属医院泌尿外科,陕西咸阳712000 [2]陕西中医药大学,陕西咸阳712000 [3]咸阳市第一人民医院泌尿外科,陕西咸阳712000

出　　处：《中国性科学》2023年第12期32-36,共5页Chinese Journal of Human Sexuality

摘　　要：目的研究血清总前列腺特异性抗原(tPSA)和前列腺素E2(PGE2)水平对良性前列腺增生(BPH)患者前列腺剜除术后疗效的预测价值。方法选取陕西省中医药大学第二附属医院于2019年3月至2023年1月收治的218例行钬激光前列腺切除术(HoLEP)的BPH患者作为研究组,另外再纳入55例行HoLEP的BPH患者作为验证组。对患者进行随访并根据疗效将研究组分为有效组(n=184)和无效组(n=34)。术前测定患者前列腺体积、前列腺突入膀胱程度、残余尿量、最大尿流率、逼尿肌收缩力、国际前列腺症状评分(IPSS)、血清tPSA及PGE2水平。结果有效组和无效组患者的年龄、平均病程、逼尿肌收缩力、术前最大逼尿肌压力、术前IPSS、术前残余尿量、前列腺突入膀胱的程度、剜除时间、前列腺切除重量、血清tPSA和PGE2水平组间比较,差异均具有统计学意义(P<0.05)。Logistic分析结果显示,血清tPSA、PGE2水平均是BPH患者术后疗效的独立危险因素。列线图模型预测术后疗效的特异度为95.45%,灵敏度为90.91%,准确率为94.55%。结论血清tPSA和PGE2水平是BPH患者术后疗效的独立危险因素,由此建立的列线图对BPH患者前列腺剜除术后疗效预测良好,具有一定的临床价值。Objective To investigate the predictive value of levels of serum total prostate specific antigen(tPSA)and prostaglandin E2(PGE2)on the efficacy of benign prostatic hyperplasia(BPH)patients after prostate enucleation.Methods A total of 218 BPH patients who underwent holmium laser enucleation of the prostate(HoLEP)admitted to Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2019 to January 2023 were selected as the study group,and another 55 BPH patients who underwent HoLEP were included as the validation group.Patients were followed up and the study group was categorized into a effective group(n=184)and an ineffective group(n=34)based on efficacy.Preoperative measurements of prostate volume,degree of prostate protrusion into the bladder,residual urine,maximal urinary flow rate,detrusor contractility,international prostate symptom scale(IPSS),serum tPSA and PGE2 levels were performed.Results The differences between the effective and ineffective groups were statistically significant(P<0.05)in terms of age,mean duration of disease,forced urethral muscle contractility,preoperative maximal forced urethral pressure,preoperative IPSS,preoperative residual urine volume,degree of prostate protrusion into the bladder,time of enucleation,weight of prostatectomy,and serum tPSA and PGE2 levels when compared between the groups.The results of Logistic regression analysis showed that the serum tPSA and PGE2 were independent risk factors for postoperative outcome in BPH patients.The specificity of the column-line diagram model for predicting postoperative outcome was 95.45%,the sensitivity was 90.91%,and the accuracy was 94.55%.Conclusions Serum tPSA and PGE2 are independent risk factors for postoperative outcome in patients with BPH,and the resulting column-line diagram can predict postoperative outcome after prostatectomy in patients with BPH well and has certain clinical value.

关 键 词：总前列腺特异性抗原 前列腺素E2 良性前列腺增生 前列腺剜除术 列线图 

分 类 号：R691[医药卫生—泌尿科学]