中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
5期
654-656
,共3页
钟兴祥%刘思平%姚史武%孙忠凯%林立国%陈智林
鐘興祥%劉思平%姚史武%孫忠凱%林立國%陳智林
종흥상%류사평%요사무%손충개%림입국%진지림
前列腺特异抗原%前列腺增生%钬激光%时间分辨荧光免疫分析法
前列腺特異抗原%前列腺增生%鈥激光%時間分辨熒光免疫分析法
전렬선특이항원%전렬선증생%화격광%시간분변형광면역분석법
Prostate specific antigen%Hyperplasia of prostate%YAG Laser%Time-resolved huorescence immunoassay
目的 探讨游离前列腺特异抗原(f-PSA)、总前列腺特异抗原(t-PSA)及f-PSA/t-PSA的比值(FPSAR)在钬激光治疗前列腺增生症中的应用价值.方法 选取良性前列腺增生(BPH)患者150例,前列腺癌(PCa)患者24例,采用时间分辨荧光免疫分析法(TRFIA)测定f-PSA、t-PSA、FPSAR值,进行统计学分析.结果 两组治疗后t-PSA,f-PSA均明显低于治疗前(t=2.984、2.701,P＜0.05),FPSAR明显高于治疗前(t =2.335,P＜0.05)；交叉重叠区(t-PSA 4～45.5 μg/L)患者以FPSAR值≤0.15为界时,鉴别诊断PCa的总灵敏度达91.7％(22/24)[t-PSA＞ 45.5 μg/L(17/24)+(t-PSA 4～45.5 μg/L,FPSAR≤0.15)(5/24)],通过高灵敏度排查PCa,为正确筛选良性前列腺增生症患者提供了比较可靠的依据.BPH组经尿道钬激光前列腺剜除术(TUEP)术后随访6～12个月,t-PSA(2.13±0.45)μg/L,、f-PSA(0.85±0.26)μg/L、FPSAR(0.39±0.06)μg/L与治疗后一个月比较无明显差异(t=1.892、1.635、1.416,P＞0.05)；国际前列腺症状评分(IPSS)由(28.3±5.8)分降至(12.5±2.1)分、生活质量评分(QOL)由(4.1±0.6)分降至(1.3±0.1)分、剩余尿量(RUV)由(93±61)ml减少至(15±9)ml、术后排尿显著改善,最大尿流率(Qmax)由术前平均6.3(2.6～9.5)ml/s提高到术后18.4(14.6～22.3)ml/s均与术前有明显差异(t=2.632、2.504、2.984、2.485,P＜0.05).结论 血清PSA检测在钬激光治疗前列腺增生症病例筛选,治疗前后水平变化的比较及术后随访中均具有重要的临床应用价值.
目的 探討遊離前列腺特異抗原(f-PSA)、總前列腺特異抗原(t-PSA)及f-PSA/t-PSA的比值(FPSAR)在鈥激光治療前列腺增生癥中的應用價值.方法 選取良性前列腺增生(BPH)患者150例,前列腺癌(PCa)患者24例,採用時間分辨熒光免疫分析法(TRFIA)測定f-PSA、t-PSA、FPSAR值,進行統計學分析.結果 兩組治療後t-PSA,f-PSA均明顯低于治療前(t=2.984、2.701,P＜0.05),FPSAR明顯高于治療前(t =2.335,P＜0.05)；交扠重疊區(t-PSA 4～45.5 μg/L)患者以FPSAR值≤0.15為界時,鑒彆診斷PCa的總靈敏度達91.7％(22/24)[t-PSA＞ 45.5 μg/L(17/24)+(t-PSA 4～45.5 μg/L,FPSAR≤0.15)(5/24)],通過高靈敏度排查PCa,為正確篩選良性前列腺增生癥患者提供瞭比較可靠的依據.BPH組經尿道鈥激光前列腺剜除術(TUEP)術後隨訪6～12箇月,t-PSA(2.13±0.45)μg/L,、f-PSA(0.85±0.26)μg/L、FPSAR(0.39±0.06)μg/L與治療後一箇月比較無明顯差異(t=1.892、1.635、1.416,P＞0.05)；國際前列腺癥狀評分(IPSS)由(28.3±5.8)分降至(12.5±2.1)分、生活質量評分(QOL)由(4.1±0.6)分降至(1.3±0.1)分、剩餘尿量(RUV)由(93±61)ml減少至(15±9)ml、術後排尿顯著改善,最大尿流率(Qmax)由術前平均6.3(2.6～9.5)ml/s提高到術後18.4(14.6～22.3)ml/s均與術前有明顯差異(t=2.632、2.504、2.984、2.485,P＜0.05).結論 血清PSA檢測在鈥激光治療前列腺增生癥病例篩選,治療前後水平變化的比較及術後隨訪中均具有重要的臨床應用價值.
목적 탐토유리전렬선특이항원(f-PSA)、총전렬선특이항원(t-PSA)급f-PSA/t-PSA적비치(FPSAR)재화격광치료전렬선증생증중적응용개치.방법 선취량성전렬선증생(BPH)환자150례,전렬선암(PCa)환자24례,채용시간분변형광면역분석법(TRFIA)측정f-PSA、t-PSA、FPSAR치,진행통계학분석.결과 량조치료후t-PSA,f-PSA균명현저우치료전(t=2.984、2.701,P＜0.05),FPSAR명현고우치료전(t =2.335,P＜0.05)；교차중첩구(t-PSA 4～45.5 μg/L)환자이FPSAR치≤0.15위계시,감별진단PCa적총령민도체91.7％(22/24)[t-PSA＞ 45.5 μg/L(17/24)+(t-PSA 4～45.5 μg/L,FPSAR≤0.15)(5/24)],통과고령민도배사PCa,위정학사선량성전렬선증생증환자제공료비교가고적의거.BPH조경뇨도화격광전렬선완제술(TUEP)술후수방6～12개월,t-PSA(2.13±0.45)μg/L,、f-PSA(0.85±0.26)μg/L、FPSAR(0.39±0.06)μg/L여치료후일개월비교무명현차이(t=1.892、1.635、1.416,P＞0.05)；국제전렬선증상평분(IPSS)유(28.3±5.8)분강지(12.5±2.1)분、생활질량평분(QOL)유(4.1±0.6)분강지(1.3±0.1)분、잉여뇨량(RUV)유(93±61)ml감소지(15±9)ml、술후배뇨현저개선,최대뇨류솔(Qmax)유술전평균6.3(2.6～9.5)ml/s제고도술후18.4(14.6～22.3)ml/s균여술전유명현차이(t=2.632、2.504、2.984、2.485,P＜0.05).결론 혈청PSA검측재화격광치료전렬선증생증병례사선,치료전후수평변화적비교급술후수방중균구유중요적림상응용개치.
Objective To explore the appliacation value of FPSAR between the serum f-PSA and t-PSA in hyperplasia of prostate by YAG Laser.Methods 150 cases with benign prostate hyperplasia(BPH)and 24 cases with prostate pcaancer were selected.The value of f-PSA、t-PSA、FPSAR was determined by TRFIA.Results The tPSA,f-PSA after treatment were significantly lower than before treatment in the two groups(t =2.984,2.701,P ＜0.05).The FPSAR after treatment was significantly higher than before treatment in the two groups(t =2.335,P ＜0.05);The patients of FPSAR≤0.05 in the overlapped field(t-PSA 4～45.5μg/L),the sensitivity of diagnosing PCa is 91.7％(22/24)[t-PSA ＞ 45.5 μg/L(17/24)+(t-PSA 4～45.5 μg/L,FPSAR ≤ 0.15)(5/24)].To examine the PCa with high sensitiveity,it provided the reliable basis for selecting BPH correctly.The patients of BPH group after TUEP was followed up for 6～12 months.The t-PSA is(2.13 ± 0.45)μg/L、f-PSA is(0.85 ± 0.26)μg/L、FPSAR is (0.39 ± 0.06)μg/L.There is no significant difference compared with that after treatment for a month.The international prostate symptom score,(I-PSS)is from(28.3 ± 5.8)points dropped to(12.5 ± 2.1)points.The quality of life,(QOL)is from(4.1 ± 0.6)points dropped to(1.3 ± 0.1)points.The residual urine volume(RUV)is form(93 ±61)ml reduced to(15 ±9)ml.The urination after operation have improvedsignificantly.The Qmax is from average 6.3(2.6～9.5)ml/s before operation raise to 18.4(14.6～22.3)ml/s after operation.Campared with the pre-operation,there is significant difference.Conclusion The application of serum PSA was impoetantin case selection hyperplasia of prostate,comparison of the level changing before and after operation and following up the patients after operation by YAG Laser.
