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[透明质酸酶在慢性前列腺炎中的新应用机会]

[New opportunities of using gialuronidase in chronic prostatitis].

作者信息

Kulchavenya E V, Shevchenko S Yu, Cherednichenko A G, Breusov A A, Vinitskiy A A

机构信息

TB Research Institute of Ministry of Health of Russia, Novosibirsk, Russia.

MC BIOVER.

出版信息

Urologiia. 2020 Jun(3):56-62.

Abstract

INTRODUCTION

The use of hyaluronidase contributes to improvement in microcirculation, destruction of biofilms and reducing of congestion in patients with chronic prostatitis. Based on this mechanism, the use Longidaza for the diagnosis of latent bacterial prostatitis was suggested.

AIM

To evaluate diagnostic and treatment capabilities of the long-acting enzyme preparation Longidaza (rectal suppositories with an activity of 3000 IU), prescribed to patients with chronic prostatitis in routine clinical practice.

MATERIALS AND METHODS

A total of 39 men with chronic prostatitis of categories II and IIIa were included in open, prospective, non-interventional, comparative, single-center study. A microbiological study of expressed prostate secretion (EPS) was performed three times, at baseline, after using two suppositories Longidaza 3000 IU and after 7 weeks of therapy. From the 1st to the 10th suppository, Longidaza was used every 48 hours, then, from the 11th to the 20th suppository, it was prescribed every 72 hours. The isolation of the pathogen was an indication for the antibiotic therapy. The treatment outcome was evaluated by using NIH-CPSI scale and laboratory and microbiological analysis of EPS.

RESULTS

Diagnostic stage. Initially, pathogens were isolated in 27 (69.2%) patients. The number of leukocytes in EPS averaged 25.9+/-2.3. The use of two suppositories Longidaza increased the number of patients with isolated pathogens to 33 (82%). In 7 out 12 patients with an initial diagnosis of abacterial prostatitis, the use of two suppositories of Longidaza contributed to isolation of the pathogen in EPS (58.3%). The number of leukocytes in the EPS after enzymatic provocation increased by 50.2%. Treatment stage. The number of patients with isolated pathogens decreased from 33 to 7 (17.9%). The pain intensity decreased on average to 2.2+/-0.4 points, and in 27 (69.2%) men dysuria resolved. The quality of life significantly improved up to 1.3+/-0.2 points. The total score on NIH-CPSI scale decreased on average from 17.3+/-1.9 to 3.9+/-0.3 (p<0.05). An increased number of white blood cells in EPS was seen only in 5 (12.8%) men.

CONCLUSION

In many cases, bacterial prostatitis remains undiagnosed. Rectal suppositories Longidaza can be recommended for the diagnosis of the latent bacterial chronic prostatitis, since this drug contributes to detection of pathogen and inflammation.

摘要

引言

透明质酸酶的使用有助于改善慢性前列腺炎患者的微循环、破坏生物膜并减轻充血。基于这一机制,有人提出使用龙地酶(Longidaza)来诊断潜伏性细菌性前列腺炎。

目的

评估长效酶制剂龙地酶(活性为3000 IU的直肠栓剂)在常规临床实践中用于慢性前列腺炎患者的诊断和治疗能力。

材料与方法

39例II类和IIIa类慢性前列腺炎男性患者纳入了一项开放、前瞻性、非干预性、对比性、单中心研究。在基线时、使用两枚3000 IU龙地酶栓剂后以及治疗7周后,对前列腺按摩液(EPS)进行了三次微生物学研究。从第1枚到第10枚栓剂,每48小时使用一次龙地酶,然后,从第11枚到第20枚栓剂,每72小时给药一次。病原体的分离是抗生素治疗的指征。通过使用美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)量表以及对EPS进行实验室和微生物学分析来评估治疗结果。

结果

诊断阶段。最初,27例(69.2%)患者分离出病原体。EPS中的白细胞数量平均为25.9±2.3。使用两枚龙地酶栓剂后,分离出病原体的患者数量增加到33例(82%)。在最初诊断为非细菌性前列腺炎的12例患者中,有7例(58.3%)使用两枚龙地酶栓剂后在EPS中分离出病原体。酶激发后EPS中的白细胞数量增加了50.2%。治疗阶段。分离出病原体的患者数量从33例减少到7例(17.9%)。疼痛强度平均降至2.2±0.4分,27例(69.2%)男性的排尿困难症状得到缓解。生活质量显著提高至1.3±0.2分。NIH-CPSI量表的总分平均从17.3±1.9降至3.9±0.3(p<0.05)。仅5例(12.8%)男性的EPS中白细胞数量增加。

结论

在许多情况下,细菌性前列腺炎仍未被诊断出来。龙地酶直肠栓剂可推荐用于诊断潜伏性细菌性慢性前列腺炎,因为这种药物有助于病原体和炎症的检测。

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