他莫昔芬对ⅲ型前列腺炎的临床疗效观察和机制探讨 - 现代临床医学.doc

2016-05-05 魏编辑加工完成 2016-10-10 董 2016-10-26 董返魏，魏送贾 他莫昔芬治疗Ⅲ型前列腺炎疗效观察 张新明，何海填，郭德迎，叶宗岳 （深圳市蛇口人民医院泌尿外科，广东 深圳 518067） [摘要]目的：观察他莫昔芬治疗Ⅲ型前列腺炎的临床疗效并探讨其作用机理。方法：将80例患者分为Ⅲ型前列腺炎合并特发少精症组28例和特发少精症组52例，均采用他莫昔芬治疗，疗程均为12周。比较2组治疗前后的前列腺常规、慢性前列腺炎症状指数（NIH-CPSI）、精浆中细胞因子的表达、勃起功能国际问卷（IIEF-5）评分。结果：治疗后，⑴Ⅲ型前列腺炎组NIH-CPSI评分显著降低（P＜0.05），IIEF-5评分显著升高（P＜0.05）；⑵Ⅲ型前列腺炎组WBC、TNF-α、IL-8、IL-10的水平显著降低（P＜0.05）。⑶2组的NIH-CPSI评分与WBC、TNF-α、IL-8、IL-10水平呈正相关，而IIEF-5评分与WBC、TNF-α、IL-8、IL-10水平呈负相关。结论：Ⅲ型前列腺炎合并特发少精症组患者通过他莫昔芬治疗，能使NIH-CPSI评分显著降低和IIEF-5评分显著提高，且减少前列腺液中炎症因子的表达。 [关键词]他莫昔芬；Ⅲ型前列腺炎；特发少精症；机理 [中图分类号]R697+.33 [文献标识码]A DOI:10.11851/j.issn.1673-1557.2016.06.0 Therapeutical Effect of Tamoxifen on Type Ⅲ Prostatitis ZHANG Xinming, HE Haitian, GUO Deying, YE Zongyue (Department of Urology Surgery, Shekou Peoples Hospital, Shenzhen, Guangdong 518067,China) [Abstract] Objective: To observe the therapeutical effect of tamoxifen on type Ⅲ prostatitis, and to discuss its mechanism of action. Methods: 80 patients were randomly divided into the two groups: type Ⅲ prostatitis with idiopathic oligospermia group (abbreviated as type Ⅲ prostatitis group, 28 cases) and idiopathic oligospermia group(52 cases). Both groups were given tamoxifen for 12-week courses of treatment. 12 weeks later, prostatic routine test, scores of National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), the expression of cytokines in seminal plasma, and International Index of Erectile Function-5 (IIEF-5) were compared between the two groups. Results: ⑴ The NIH-CPSI score of type Ⅲ prostatitis group significantly decreased （P＜0.05) while the IIEF-5 score significantly increased after treatment（P＜0.05). ⑵Type Ⅲ prostatitis group indicated significantly lower levels of WBC, TNF-α, IL-8 and IL-10 （P＜0.05). ⑶The NIH-CPSI score had a positive correlation with the levels of WBC, TNF-α, IL-8 and IL-10 while the IIEF-5 score was negatively related to these indexes in the two groups. Conclusion: The treatment of type Ⅲ prostatitis wi