本文選題：慢性前列腺炎　切入點：NIH-IV　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探究無癥狀性前列腺炎(NIH-IV型)與血清tPSA水平的關(guān)系。 方法研究數(shù)據(jù)來源于2009年9月-12月期間本課題組在廣西防城港地區(qū)開展的男性健康體檢調(diào)查。調(diào)查由經(jīng)統(tǒng)一培訓(xùn)合格的專業(yè)人員進(jìn)行，采用統(tǒng)一標(biāo)準(zhǔn)設(shè)計的調(diào)查問卷，以面對面的形式，采集包括NIH-CPSI總評分、社會人口學(xué)資料、生活方式、用藥及手術(shù)史等基本信息，并結(jié)合調(diào)查對象的人體學(xué)參數(shù)，構(gòu)成本研究的基本數(shù)據(jù)和初始研究隊列；此外，還采集禁食8小時的空腹靜脈血標(biāo)本，對總PSA（tPSA）、甘油三酯、高密度脂蛋白、膽固醇和空腹血糖等生化指標(biāo)進(jìn)行檢測。所有參與體檢的男性個體都被建議進(jìn)行男科檢查并進(jìn)行前列腺按摩，以獲取前列腺液標(biāo)本，于顯微鏡下進(jìn)行前列腺液常規(guī)鏡檢，了解白細(xì)胞含量狀況。最后，根據(jù)美國國立衛(wèi)生研究院（NIH）前列腺炎的分型標(biāo)準(zhǔn)，以及NIH-CPSI評分，把研究人群分成無癥狀性前列腺炎組(NIH-IV型)與健康對照組，利用T檢驗、卡方檢驗及邏輯回歸的統(tǒng)計學(xué)方法進(jìn)行分析。 結(jié)果血清tPSA水平在健康對照組和NIH-IV型前列腺炎組分別為0.91和1.27(ng/ml),標(biāo)準(zhǔn)差為0.79和1.52(ng/ml),差異有統(tǒng)計學(xué)意義(P值0.001)。在兩組人群中，受教育程度、運動、高血壓在健康對照組更高，構(gòu)成比有統(tǒng)計學(xué)差異（P值=0.002，P值=0.007，P值=0.011）。年齡、甘油三酯、收縮壓、舒張壓在NIH-IV型前列腺炎組更高，均值有統(tǒng)計學(xué)差異（P值0.001，P值=0.044，P值=0.007，P值=0.048）。然而BMI、總膽固醇、血清高密度脂蛋白、血清低密度脂蛋白、空腹血糖的均值在兩組人群之間不存在統(tǒng)計學(xué)差異。同樣，兩組人群的飲酒、血脂異常、肥胖、糖尿病、吸煙之間的構(gòu)成比亦不存在統(tǒng)計學(xué)差異。將血清tPSA水平按照從低到高的順序排列后分為4等分，分別為Q1、Q2、Q3、Q4組，比較NIH-IV型前列腺炎患病的風(fēng)險度，結(jié)果表明在NIH-IV型前列腺炎(wbc≥3+)組對比健康對照組，隨著血清tPSA水平遞增比值比（odds ratios，OR）也是遞增的，OR值分別是1.078、3.589、4.406。在血清tPSA Q4組中隨著炎癥的增加OR值也遞增，OR值分別是1.573、3.147、4.406。利用二分類邏輯回歸模型進(jìn)行分析，進(jìn)一步加入年齡、教育水平、血脂異常、糖尿病、高血壓、BMI、抽煙、飲酒、運動、舒張壓、收縮壓作為調(diào)整變量。結(jié)果顯示，血清tPSA水平越高其患NIH-IV型前列腺炎的風(fēng)險越大。加入年齡后（模型1），以Q1組為參考組，NIH-IV型前列腺炎組中Q2、Q3、Q4組OR值分別為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值趨勢檢驗，P值0.05。繼續(xù)加入教育水平、血脂異常、糖尿病、高血壓、BMI、抽煙、飲酒、運動、舒張壓、收縮壓作為調(diào)整變量后（模型2），結(jié)果顯示Q2、Q3、Q4組OR值分別為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值趨勢檢驗，P值0.01。再進(jìn)一步根據(jù)WBC計數(shù)將NIH-IV型前列腺炎為分為wbc=1+、wbc=2+、wbc≥3+三個亞組后，在NIH-IV型前列腺炎（wbc≥3+）亞組中，以Q1組為參考組，模型1結(jié)果顯示Q2、Q3、Q4組OR值分別為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值趨勢檢驗，P值0.001。模型2結(jié)果顯示Q2、Q3、Q4組OR值分別為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值進(jìn)行趨勢檢驗，P值0.01。 結(jié)論高水平的血清tPSA是NIH-IV型前列腺炎的一個風(fēng)險；NIH-IV型前列腺炎患者前列腺按摩液中白細(xì)胞含量與血清tPSA水平呈正相關(guān)。
[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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