Tchetgen M B, Song J T, Strawderman M, Jacobsen S J, Oesterling J E
Michigan Prostate Institute, University of Michigan, Ann Arbor 48109, USA.
Urology. 1996 Apr;47(4):511-6. doi: 10.1016/S0090-4295(99)80486-5.
To determine the effect of ejaculation on the serum prostate-specific antigen (PSA) concentration in men at risk for developing prostate cancer.
A prospective, community-based study was conducted in which 64 men, aged 49 to 79 years, underwent a serum PSA determination immediately before ejaculation (baseline) and at 1 hour, 6 hours, and 24 hours following ejaculation. The serum PSA also was measured 48 hours and 1 week after ejaculation if the concentration had not returned to the baseline value by the previous time interval. All subjects abstained from ejaculation for a minimum of 7 days prior to the study and until the PSA concentration returned to the baseline level. Absolute and relative change in serum PSA concentration, as well as the time to return to baseline PSA concentration following ejaculation, were assessed.
The serum PSA concentration increased following ejaculation in 87% of the subjects. The mean baseline PSA was 1.8 ng/mL (median, 0.7 ng/mL). The mean absolute PSA change +/- standard deviation 1 hour, 6 hours, 24 hours, and 48 hours after ejaculation was 0.8 +/- 1.32 ng/mL, 0.3 +/- 0.66 ng/mL, 0.2 +/- 0.33 ng/mL, and 0.4 +/- 0.40 ng/mL, respectively. The mean relative PSA change +/- standard error 1 hour, 6 hours, 24 hours, and 48 hours after ejaculation was 41 +/- 4%, 9 +/- 1.5%, 8 +/- 1.3%, and 10 +/- 2.3%, respectively. The absolute and relative changes in PSA concentration noted 1 hour, 6 hours, and 24 hours after ejaculation were statistically significant (P = 0.0001). A strong correlation was observed between absolute change in PSA and baseline serum PSA, at each time interval (1 hour: r = 0.68, 6 hours: r = 0.77, 24 hours: r = 0.70; P < 0.0001) after ejaculation. Similarly, a significant correlation was noted between absolute change in PSA and patient age at each time interval (1 hour: r = 0.37, 6 hours: r = 0.38; P = 0.002, 24 hours: r = 0.55; P < 0.0001). Ninety-two percent of subjects returned to baseline by 24 hours (95% confidence interval (Cl) = 83% to 97%), whereas 97% of subjects returned to baseline by 48 hours (95% Cl = 89% to 99%).
Ejaculation causes a significant increase in the serum PSA concentration in men between 49 and 79 years of age that may persist for up to 48 hours. This change appears to correlate with age and baseline PSA. It is recommended that men abstain from ejaculation for 48 hours prior to having a serum PSA determination.
确定射精对有患前列腺癌风险男性血清前列腺特异性抗原（PSA）浓度的影响。
开展了一项基于社区的前瞻性研究，64名年龄在49至79岁的男性在射精前（基线）以及射精后1小时、6小时和24小时进行血清PSA测定。如果在前一时间间隔血清PSA浓度未恢复到基线值，则在射精后48小时和1周时也进行测量。所有受试者在研究前至少禁欲7天，直至PSA浓度恢复到基线水平。评估血清PSA浓度的绝对和相对变化，以及射精后恢复到基线PSA浓度的时间。
87%的受试者射精后血清PSA浓度升高。平均基线PSA为1.8 ng/mL（中位数为0.7 ng/mL）。射精后1小时、6小时、24小时和48小时PSA的平均绝对变化±标准差分别为0.8±1.32 ng/mL、0.3±0.66 ng/mL、0.2±0.33 ng/mL和0.4±0.40 ng/mL。射精后1小时、6小时、24小时和48小时PSA的平均相对变化±标准误分别为41±4%、9±1.5%、8±1.3%和10±2.3%。射精后1小时、6小时和24小时PSA浓度的绝对和相对变化具有统计学意义（P = 0.0001）。在射精后的每个时间间隔，PSA的绝对变化与基线血清PSA之间均观察到强相关性（1小时：r = 0.68，6小时：r = 0.77，24小时：r = 0.70；P < 0.0001）。同样，在每个时间间隔，PSA的绝对变化与患者年龄之间也存在显著相关性（1小时：r = 0.37，6小时：r = 0.38；P = 0.002，24小时：r = 0.55；P < 0.0001）。92%的受试者在24小时时恢复到基线水平（95%置信区间（Cl）= 83%至97%），而97%的受试者在48小时时恢复到基线水平（95% Cl = 89%至99%）。
射精会使49至79岁男性的血清PSA浓度显著升高，且这种升高可能持续长达48小时。这种变化似乎与年龄和基线PSA相关。建议男性在进行血清PSA测定前禁欲48小时。
