Pannek Jürgen, Berges Richard R, Cubick Goetz, Meindl Renate, Senge Theodor
Department of Urology, Ruhr-Universität Bochum, Herne, Germany.
Urology. 2003 Nov;62(5):845-8. doi: 10.1016/s0090-4295(03)00654-x.
To evaluate prostate size and serum prostate-specific antigen (PSA) levels in male patients with spinal cord injury (SCI). As a result of improved medical care, the life expectancy in patients with SCI today equals the life expectancy of the general population. Therefore, male patients with SCI are likely to develop benign prostatic hyperplasia or prostate cancer. Although animal experiments indicate that neurogenic factors play an important role in prostate growth, the influence of these factors is not well examined in humans.
The data of 100 male patients with SCI and 575 noninjured men were evaluated. The inclusion criteria were age older than 35 years and SCI for longer than 2 years. The exclusion criteria were previous prostate surgery, acute urinary tract infection, and bladder or prostate cancer. PSA was measured by an immunoenzymatic assay, and the prostatic volume was assessed by transrectal ultrasonography. For analysis, patients were grouped according to age.
With increasing age, the mean prostate volume increased in the patients with SCI and in the control group. The mean PSA level increased with age in the control group and to a far lesser extent in the patients with SCI. Neither for the entire cohort nor for the subgroups delineated by age were the differences in mean PSA level and mean prostate volume between patients with SCI and the control group statistically significant.
Prostate growth is detectable in patients with SCI. Although there is a tendency toward a lower prostate volume and lower serum PSA level in patients with SCI, the differences were not statistically significant. According to our results, the reference ranges for PSA levels are not vastly different from the general reference ranges.
评估男性脊髓损伤（SCI）患者的前列腺大小和血清前列腺特异性抗原（PSA）水平。由于医疗护理的改善，如今SCI患者的预期寿命与普通人群相当。因此，男性SCI患者很可能会发生良性前列腺增生或前列腺癌。尽管动物实验表明神经源性因素在前列腺生长中起重要作用，但这些因素对人类的影响尚未得到充分研究。
对100例男性SCI患者和575例未受伤男性的数据进行评估。纳入标准为年龄大于35岁且SCI病程超过2年。排除标准为既往有前列腺手术史、急性尿路感染以及膀胱或前列腺癌。采用免疫酶法测定PSA，经直肠超声评估前列腺体积。为进行分析，根据年龄对患者进行分组。
随着年龄增长，SCI患者和对照组的平均前列腺体积均增加。对照组中平均PSA水平随年龄增加，而SCI患者中平均PSA水平的升高幅度要小得多。无论是整个队列还是按年龄划分的亚组，SCI患者与对照组之间的平均PSA水平和平均前列腺体积差异均无统计学意义。
SCI患者中可检测到前列腺生长。尽管SCI患者有前列腺体积较小和血清PSA水平较低的趋势，但差异无统计学意义。根据我们的结果，PSA水平的参考范围与一般参考范围差异不大。
