经直肠超声联合前列腺按摩液对Ⅲ型前列腺炎的诊断价值  

Diagnostic value of transrectal ultrasonography combined with prostatic massage fluid for typeⅢprostatitis

作　　者：谢迎东 戴云 徐超丽 徐军[3] XIE Yingdong;DAI Yun;XU Chaoli;XU Jun(Department of Ultrasound Diagnostic,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China;Department of Ultrasound,First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial People′s Hospital,Nanjing 210029,Jiangsu,China;Department of Ultrasound,The People′s Hospital of Binhai,Yancheng 224599,Jiangsu,China)

机构地区：[1]东部战区总医院超声诊断科,南京210002 [2]南京医科大学第一附属医院超声科,南京210029 [3]盐城市滨海县人民医院超声科,盐城224599

出　　处：《医学研究与战创伤救治》2023年第10期1061-1065,共5页Journal of Medical Research & Combat Trauma Care

摘　　要：目的 经直肠超声联合前列腺按摩液对Ⅲ型前列腺炎的诊断价值。方法 回顾性分析2018年1月至2022年12月在东部战区总医院诊断为Ⅲ型前列腺炎男性患者71例(Ⅲ型前列腺炎组),选取222例健康受试者作为对照组,均行经直肠超声及前列腺按摩液检查。比较2组患者临床资料、经直肠超声成像特征及前列腺按摩液的差异。使用Logistic回归分析筛鉴别Ⅲ型前列腺炎的特征因素,并建立ROC曲线评价诊断效能。结果 单因素分析结果显示,与对照组相比,Ⅲ型前列腺炎组经直肠超声测量前列腺外腺[(43.2±16.5)mm vs(49.3±18.8)mm]及内腺[(45.7±5.7)mm vs(50.3±6.7)mm]更大;此外,前列腺回声减低更显著,血流信号更丰富,弹性评分更高,以及双侧精囊回声减低更显著,差异均有统计学意义(P<0.05)。前列腺按摩液结果显示Ⅲ型前列腺炎患者前列腺按摩液弹性蛋白酶含量高于对照组[(600.5±366.3)ng/mL vs(188.3±207.4)ng/mL],差异具有统计学意义(P<0.05)。通过Logistic回归分析,前列腺外腺左右径(OR 1.118,95%CI 1.016~1.230,P=0.022)、前列腺回声减低(OR 3.326,95%CI 1.376~8.037,P=0.008)、前列腺弹性评分4分(OR 5.484,95%CI 1.002~1.005,P=0.000)、前列腺按摩液弹性蛋白酶含量(OR 1.004,95%CI 1.368~18.224,P=0.015)为诊断Ⅲ型前列腺炎的特征。其ROC曲线下面积为0.898,敏感性为88.7%,特异性为84.5%。结论 经直肠超声显示前列腺回声减低、弹性评分增加联合前列腺按摩液弹性蛋白酶增加有助于诊断Ⅲ型前列腺炎,可为临床提供相关诊断依据。Objective To explore the diagnostic performance of transrectal ultrasonography combined with prostatic massage fluid for typeⅢprostatitis.Methods A retrospective analysis was performed on 71 male patients diagnosed with typeⅢchronic prostatitis(TypeⅢprostatitis group)in the General Hospital of the Eastern Theater of Operations from January 2018 to December 2022,and 222 healthy subjects were selected as the control group.All of them underwent transrectal ultrasound and prostate massage fluid examination.The difference of theclinical data,thecharacteristics of transrectal ultrasound imaging and the prostatic massage fluid between the two groupswere compared.Logistic regression analysis was used to identify the characteristic factors of typeⅢprostatitis,and ROC curve was established to evaluate the diagnostic efficiency.Results Univariate analysis showed that,compared to control group,the typeⅢprostatitis group possessed a larger size of external(43.2±16.5 vs 49.3±18.8 mm)and internal(45.7±5.7 vs 50.3±6.7mm)prostate glands,with stronger hypoecho of prostate,higher blood flow signal and higher elasticity score,as well asstronger hypoe-cho of bilateral seminal vesicle evaluated by transrectal ultrasound.The difference was statistically significant(P<0.05).The results of prostatic massage fluid showed that the content of elastase in typeⅢprostatitis was higher than that in control group(600.5±366.3 vs 188.3±207.4 ng/mL),and the difference was statistically significant(P<0.05).Logistic regression analysis showed that external prostatic gland diameter(OR 1.118,95%CI 1.016-1.230,P=0.022),decreasedprostatic echo(OR 3.326,95%CI 1.376-8.037,P=0.008),prostatic elasticity score of4 points(OR 5.484,95%CI 1.002-1.005,P=0.000),and the prostatic fluid elastase con-tent(OR 1.004,95%CI 1.368-18.224,P=0.015)were the diagnostic features of typeⅢprostatitis.The area under ROC curve was 0.898,the sensitivity was 88.7%,and the specificity was 84.5%.Conclusion Transrectal ultrasonography showing reduced prostate echo a

关 键 词：经直肠超声 Ⅲ型前列腺炎 前列腺按摩液 弹性蛋白酶 

分 类 号：R445.1[医药卫生—影像医学与核医学]