防城港地区男性无症状性前列腺炎（NIH-Ⅳ型）与血清tPSA水平关系的研究

发布时间：2018-03-11 22:29

  本文选题：慢性前列腺炎　切入点：NIH-IV　出处：《广西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探究无症状性前列腺炎(NIH-IV型)与血清tPSA水平的关系。 方法研究数据来源于2009年9月-12月期间本课题组在广西防城港地区开展的男性健康体检调查。调查由经统一培训合格的专业人员进行，采用统一标准设计的调查问卷，以面对面的形式，采集包括NIH-CPSI总评分、社会人口学资料、生活方式、用药及手术史等基本信息，并结合调查对象的人体学参数，构成本研究的基本数据和初始研究队列；此外，还采集禁食8小时的空腹静脉血标本，对总PSA（tPSA）、甘油三酯、高密度脂蛋白、胆固醇和空腹血糖等生化指标进行检测。所有参与体检的男性个体都被建议进行男科检查并进行前列腺按摩，以获取前列腺液标本，于显微镜下进行前列腺液常规镜检，了解白细胞含量状况。最后，根据美国国立卫生研究院（NIH）前列腺炎的分型标准，以及NIH-CPSI评分，把研究人群分成无症状性前列腺炎组(NIH-IV型)与健康对照组，利用T检验、卡方检验及逻辑回归的统计学方法进行分析。 结果血清tPSA水平在健康对照组和NIH-IV型前列腺炎组分别为0.91和1.27(ng/ml),标准差为0.79和1.52(ng/ml),差异有统计学意义(P值0.001)。在两组人群中，受教育程度、运动、高血压在健康对照组更高，构成比有统计学差异（P值=0.002，P值=0.007，P值=0.011）。年龄、甘油三酯、收缩压、舒张压在NIH-IV型前列腺炎组更高，均值有统计学差异（P值0.001，P值=0.044，P值=0.007，P值=0.048）。然而BMI、总胆固醇、血清高密度脂蛋白、血清低密度脂蛋白、空腹血糖的均值在两组人群之间不存在统计学差异。同样，两组人群的饮酒、血脂异常、肥胖、糖尿病、吸烟之间的构成比亦不存在统计学差异。将血清tPSA水平按照从低到高的顺序排列后分为4等分，分别为Q1、Q2、Q3、Q4组，比较NIH-IV型前列腺炎患病的风险度，结果表明在NIH-IV型前列腺炎(wbc≥3+)组对比健康对照组，随着血清tPSA水平递增比值比（odds ratios，OR）也是递增的，OR值分别是1.078、3.589、4.406。在血清tPSA Q4组中随着炎症的增加OR值也递增，OR值分别是1.573、3.147、4.406。利用二分类逻辑回归模型进行分析，进一步加入年龄、教育水平、血脂异常、糖尿病、高血压、BMI、抽烟、饮酒、运动、舒张压、收缩压作为调整变量。结果显示，血清tPSA水平越高其患NIH-IV型前列腺炎的风险越大。加入年龄后（模型1），以Q1组为参考组，NIH-IV型前列腺炎组中Q2、Q3、Q4组OR值分别为1.45(95%CI0.92-2.34)、1.60(95%CI1.00-2.54)*、2.15(95%CI1.37-3.36)*，*表示P值0.05，OR值趋势检验，P值0.05。继续加入教育水平、血脂异常、糖尿病、高血压、BMI、抽烟、饮酒、运动、舒张压、收缩压作为调整变量后（模型2），结果显示Q2、Q3、Q4组OR值分别为1.46(95%CI0.91-2.35)、1.62(95%CI1.01-2.60)*、2.11(95%CI1.33-3.33)*，*表示P值0.05，，OR值趋势检验，P值0.01。再进一步根据WBC计数将NIH-IV型前列腺炎为分为wbc=1+、wbc=2+、wbc≥3+三个亚组后，在NIH-IV型前列腺炎（wbc≥3+）亚组中，以Q1组为参考组，模型1结果显示Q2、Q3、Q4组OR值分别为1.10(95%CI0.27-4.49)、3.59(95%CI1.15-11.25)*、4.13(95%CI1.32-12.87)*，*表示P值0.05，OR值趋势检验，P值0.001。模型2结果显示Q2、Q3、Q4组OR值分别为1.08(95%CI0.26-4.43)、3.88(95%CI1.22-12.32)*、4.00(95%CI1.27-12.63)*，*表示P值0.05，其OR值进行趋势检验，P值0.01。 结论高水平的血清tPSA是NIH-IV型前列腺炎的一个风险；NIH-IV型前列腺炎患者前列腺按摩液中白细胞含量与血清tPSA水平呈正相关。
[Abstract]:Objective to explore the relationship between the level of serum tPSA and asymptomatic prostatitis (type NIH-IV).
The method of data source in the study group during the month of September 2009 -12 men's health examination surveys carried out in Guangxi Fangchenggang area. Surveyed by the trained qualified professionals, by questionnaire design standard, in the form of face to face, including the acquisition of NIH-CPSI total score, social demographic, lifestyle, medication and surgery the basic information, and combined with the survey of the anthropometric parameters, constitute the basic data of this study and the initial cohort study; in addition, also collected 8 hours of fasting fasting venous blood samples of total PSA (tPSA), triglyceride, high density lipoprotein cholesterol and fasting blood glucose and other biochemical indexes were detected. All participate in the examination the male individuals are advised to check male and prostate massage, in order to obtain specimens of prostate fluid, prostate fluid routine examination under the microscope, understand The status of white blood cell content. Finally, according to the National Institutes of Health (NIH) classification standard of prostatitis, and NIH-CPSI score, the study population was divided into asymptomatic prostatitis group (NIH-IV) and the control group by using T test and statistical method of chi square test and logistic regression analysis.
Results the serum tPSA level in healthy control group and type NIH-IV prostatitis group were 0.91 and 1.27 (ng/ml), the standard deviation is 0.79 and 1.52 (ng/ml), the difference was statistically significant (P = 0.001). In two groups, education, sports, hypertension in healthy control group is higher than that of there were significant differences (P = =0.002, P =0.007, P =0.011). The age, triglycerides, systolic blood pressure, diastolic blood pressure in type NIH-IV prostatitis was higher, mean a significant difference (P = 0.001, P value =0.044, P value =0.007, P value =0.048 BMI). However, serum total cholesterol, high density lipoprotein, serum low density lipoprotein, the mean fasting blood glucose there were no statistical differences between the two groups. The same two groups, drinking, dyslipidemia, obesity, diabetes, smoking a ratio between is not statistically significant. The serum level of tPSA in accordance with the order from low to high after Divided into 4 parts, respectively Q1, Q2, Q3, Q4 group, NIH-IV type prostatitis risk degree, result in type NIH-IV prostatitis (WBC = 3+) compared with healthy controls, the serum level of tPSA increased the odds ratio (odds ratios OR) is also increasing, the OR value is 1.078,3.589,4.406. the serum tPSA in Q4 group with inflammation increased OR value also increased, OR values were 1.573,3.147,4.406. using two classification logistic regression model analysis, further addition of age, level of education, dyslipidemia, diabetes, hypertension, BMI, smoking, drinking, exercise, diastolic blood pressure, systolic blood pressure as adjustment variables. The results showed that the higher level of serum tPSA in the patients of type NIH-IV prostatitis. The greater the risk of adding age (model 1), in the Q1 group as the reference group, Q2, NIH-IV in type Q3 prostatitis group, Q4 group, OR = 1.45 (95%CI0.92-2.34), 1.60 (95%CI1.00-2.54) * 2.15 (95 %CI1.37-3.36)*,*琛ㄧずP鍊

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