摘要
目的探讨前列腺增生患者行尿道前列腺等离子双极电切术(TUPKP)前后的血清前列腺特异性抗原(PSA)、血管内皮生长因子(VEGF)、热休克蛋白(HSP)水平变化的临床意义。方法回顾性分析某院2018年1月至2019年1月行TUPKP的97例良性前列腺增生患者,对比患者在TUPKP术前、术后14 d的血清PSA、VEGF、HSP水平变化,并根据患者术后预后情况分为两组,预后良好组65例及预后不良组32例,对两组的血清PSA、VEGF、HSP水平与预后结果进行单因素方差分析与多因素非条件Logistic分析,并采用ROC曲线探究联合检测三种因子对患者预后的影响。结果97例患者在术后14 d的血清PSA水平高于术前,术后14 d的血清VEGF水平、HSP水平均低于术前,差异具有高度统计学意义(P<0.001);年龄、术前是否合并高血压、术前是否合并糖尿病、术后14 d血清PSA降低、术后14 d血清VEGF升高、术后14 d血清HSP升高是良性前列腺增生患者TUPKP术后14 d发生不良预后的危险因素(P<0.05);多因素Logistic分析显示,术前是否合并高血压、术后14 d血清PSA降低、术后14 d血清VEGF升高、术后14 d血清HSP升高是TUPKP术后发生不良预后的独立危险因素(P<0.05);术后14 d血清PSA、VEGF、血清HSP水平预测发生不良预后的ROC曲线下面积分别为0.815、0.793、0.785,最佳临界点分别为7.23 ng/mL、115.54 pg/mL、8.51 pg/L,敏感度为0.846(55/65)、0.800(52/65)、0.769(50/65),特异度为0.625(20/32)、0.656(21/32)、0.719(23/32),三种因子联合预测发生不良预后的ROC曲线下面积为0.825,敏感度为0.846(55/65),特异度为0.750(24/32)。结论术后14 d血清PSA水平、VEGF、HSP表达可以较好地预测前列腺增生患者TUPKP术后预后情况,对TUPKP术后患者有计划地进行血清PSA、VEGF、HSP水平的检测有利对患者预后的评估。
Objective To investigate the clinical significance of the changes of serum prostate-specific antigen(PSA),vascular endothelial growth factor(VEGF),and heat shock protein(HSP)levels in patients with prostatic hyperplasia before and after transurethral plasma kinetic prostatectomy(TUPKP).Methods Retrospective analysis was performed on 97 patients with benign prostatic hyperplasia who underwent TUPKP from January 2018 to January 2019.Changes in serum PSA,VEGF,and HSP of the patients before and 14 days after TUPKP were compared.According to the postoperative prognosis,the patients were divided into two groups,65 patients in the group with good prognosis and 32 patients in the group with poor prognosis.One-way ANOVA and multivariate non-conditional Logistic analysis were performed on the serum PSA,VEGF and HSP levels and the prognosis of the two groups.The ROC curve was used to explore the combined impact of the three factors on the prognosis of the patients.Results The serum PSA level of 97 patients on the 14th day after TUPKP was higher than that before TUPKP,while the serum VEGF level and HSP level on the 14th day after TUPKP were both lower than those before TUPKP,the difference was highly statistically significant(P<0.001).Age,preoperative hypertension,preoperative diabetes,reduced serum PSA on the 14th day after TUPKP,elevated serum VEGF on the 14th day after TUPKP,and elevated serum HSP on the 14th day after TUPKP were risk factors for poor prognosis in BPH patients on the 14th day after TUPKP(P<0.05).Multivariate Logistic analysis showed that preoperative hypertension,reduced serum PSA on the 14th day after TUPKP,elevated serum VEGF on the 14th day after TUPKP,and elevated HSP on the 14th day after TUPKP were independent risk factors for poor prognosis after TUPKP(P<0.05).The area under the ROC curve of serum PSA,VEGF and SERUM HSP on the 14th day after TUPKP for predicting poor prognosis were 0.815,0.793 and 0.785,respectively.The optimal critical points were 7.23 ng/mL,115.54 pg/mL and 8.51 pg/L,respectively
作者
王文涛
王伽利
Wang Wentao;Wang Jiali
出处
《中国疗养医学》
2021年第3期229-232,共4页
Chinese Journal of Convalescent Medicine
