泌尿系统疾病诊断和治疗操作对血清前列腺特异抗原检测的影响

摘要

目的：评估泌尿系统疾病诊断和治疗操作对血清前列腺特异抗原（PSA ）检测的影响。方法将80例在深圳市中医院泌尿外科住院的男性患者纳入该研究，其中进行了直肠指检（DRE）的为13例，导尿术10例，硬式膀胱镜12例，前列腺活检术17例，经尿道前列腺切除术（TURP）28例。80例患者分别于泌尿系统疾病诊断和治疗操作前及操作后24 h、3 d、7 d、14 d采集血液标本进行血清总前列腺特异抗原（TPSA）和游离前列腺特异抗原（FPSA）测定。结果 DRE操作对 TPSA和 FPSA水平没影响，操作前后TPSA、FPSA水平差异均无统计学意义（P＞0．05）；导尿术和膀胱镜检查均能使血清 TPSA和FPSA水平升高，操作前后比较差异有统计学意义（P＜0．05），且持续时间较长（7～14 d）。活检术和TURP术后24 h血清TPSA和FPSA水平明显升高，差异有统计学意义（P＜0．05），第3天开始降低，第14天血清TPSA和FPSA水平降至基线。结论 DRE对血清TPSA和FPSA检测没影响，而导尿术、膀胱镜、活检术和TURP等可使血清TPSA和FPSA水平不同程度地升高，但维持时间长短不同。%Objective To evaluate the effects of diagnostic and treatment manipulation of the urinary diseases on serum prostate specific antigen(PSA) levels .Methods 80 male patients were recruited from urology surgery department of Shenzhen Tranditional Chinese Medicine (TCM ) Hospital ,Which included 13 cases with digital rectal examination (DRE) ,10 cases with catheterization , 12 cases with rigid cystoscopy ,17 cases with prostate biopsy ,28 cases with transurethral resection of the prostate (TURP) .Blood samples of 80 patients were collected before diagnostic and treatment manipulation of the urinary diseases and 24 h ,3 d ,7 d ,14 d af‐ter that ,respectively .Then ,serum total prostate antigen(TPSA) and free prostate antigen (FPSA) was measured .Results There was no effects of DRE on serum TPSA and FPSA levels(P>0 .05) .On the contrary ,serum TPSA and FPSA levels increased sig‐nificantly in patients with catheterization and cystoscopy(P<0 .05) ,and the duration was longer(7-14 d) .Serum TPSA and FPSA levels increased significantly(P<0 .05)in patients with TURP and biopsy at the 24th hour after manipulation and it began to de‐crease on the third day .Also ,the serum TPSA and FPSA levels decreased to baseline after 14 days .Conclusion There′re no effects of DRE on serum TPSA and FPSA levels .However ,serum TPSA and FPSA levels increase differently in patients with catheteriza‐tion ,cystoscopy ,biopsy and TURP ,but the durations were different ,too .