检索历史 清除

目的 探讨细菌在慢性前列腺炎(CP)中的致病作用.方法 前列腺标本取自2002-2008年192例猝死于非前列腺疾病的器官捐献者,年龄20～38岁.取周围带组织并分两块,一块前列腺组织行病理检查及白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)、免疫球蛋白A(IgA)的免疫组化分析;另一块行细菌16S rRNA基因(16S rDNA)PCR分析.结果 33.3%(64/192)的前列腺组织病理呈CP改变.细菌16S rDNA总阳性率为19.8%(38/192),而在CP标本中16S rDNA阳性率为50.0%(32/64),非CP标本中16S rDNA阳性率为4.6%(6/128),CP组16S rDNA阳性率高于非CP组(x2=55.185,P<0.001).IL-1β、TNF-α和IgA的表达在CP组中明显高于非CP标本(P<0.01),且三者表达呈正相关(P<0.01);在64例CP组织标本中,16S rDNA阳性者IL-1β、TNF-α和IgA的表达明显高于16S rDNA阴性者(P<0.01).结论 前列腺组织中细菌16S rDNA、细胞因子和免疫球蛋白A的表达增加和前列腺组织病理炎症改变相关,提示细菌感染可能是CP的重要病因.

Objective To investigate the role of bacteria in the etiology of chronic prostatitis.Methods Complete prostate specimens were obtained at autopsy from 192 organ donors (aged 20 - 38 years old) during 2002 to 2008 who died of non-prostatic diseases.One tissue taken from the peripheral prostatic zone according to McNeal was divided into two pieces.One piece of tissue was taken for routine pathological examinations and immunohistochemical studies of interleukin (IL) -1β, tumor necrosis factor-α (TNF-α)and IgA.Another one was taken for PCR assay to detect the bacterial 16S rRNA genes ( 16S rDNA ).Results Of 192 prostate specimens, 64 (33.3%) had pathological changes of chronic prostatitis and 38 ( 19.8% ) specimens was positive for bacterial 16S rDNA.Positive rates of 16S rDNA in chronic prostatitis and non-prostatitis specimens were 50.0% (32/64) and 4.6% (6/128) respectively ( X2 = 55.185, P <0.001 ).Expressions of IL-1 β, TNF-α and IgA in specimens of chronic prostatitis were significantly higher than those in non-prostatitis specimens ( P < 0.001 ).A positive correlation could be found among three immunohistochemical indicators (P < 0.01 ).In 64 specimens with chronic prostatitis, a significant expression of IL-1β, TNF-α and IgA was more often demonstrated in 16S rDNA positive group than in 16S rDNA negative group (P <0.001 ).Conclusions The up-regulations of bacterial 16S rDNA, cytokines and immunoglobulin A are involved in inflammatory response of chronic prostatitis.Bacterial infection may be an important cause of chronic prostatitis.