Influences Of PVP On The Serum Interluekin-6,C-Reactive Protein And Endothelin-1 In Patients In Patients With Benign Prostatic Hyperplasia

Background With the time of"old people"coming,the old patients of benigh prostate hyperplasia are more and more,and the patients incombined with heart disease are alse becoming more and more. The safety of operation has been thought the first factor by both doctors and patients.our department has indraughted the treatment system of GreenlightPVP manufactured by American LASERSCOPE company, and the amount of patients who have received this treatment has been over 300 by now, the kinds of operation included transurethral Photoselective vaporization(PVP), at the same time ,the kind of transurethral Resection of the Prostate(TURP) combined with PVP, which is the innovation by ourselves through clinical practicing, also has been applied in our clinical work. Investigators overseas had used the CRP and IL-6 as the guidelines to evaluate the traumatic extent in some experimentations, including the comparement between traditional surgry and laparoscopic surgery. And the result is successful.Other investigators had used ET as the serum guideline to research the changement before and after the surgry of benigh prostatic hyperplasia (BPH), the result had revealed that the traditional surgery of BPH would add the risk of heart disease in patients with BPH during perioperative period.Objective and methods To accurately quantize the traumatic dgree of PVPand its reformative treatment which is the newest surgery for BPH, and compare with the traditional surgery.for the more, to research if the new treatment would reduce the stroke of CHD in paitients with BPH during perioperative period.in the first test,we selected the CRP and IL-6 as serum parameters,through concurrent clinical control test,we selected 98 patients with BPH who had received the surgical treatment of OP,PVP+TURP or PVP respectively, the serum CRP and IL-6 were measured by ELISA before and after the operative procedure.in the second test,we selected 34 patients who had received the surgical treatment of OP,the other 38 patients who had recieved the treatment of PVP. All 72 patients were divided into 2 groups according to whether BPH was combined with CHD or not (CHD group and non-CHD group). The serum level of ET-1 was measured by ELISA before and after treatment,respectively. Result 1.The preoperative levels of both serum IL-6 and CRP showed no significant difference among the three groups.At 24h after operation,the level of serum IL-6 and CRP became significantly higher than the preoperative level in all the groups(P<0.05):OPgroup>PVP+TURPgroup>PVPgroup, with OP being the highest and PVP the lowest. At 48h after operation,the level of serum CRP also became significantly higher than the preoperative level, in all the groups (P<0.05).2.in the second test,the levels of ET-1 in CHD groups before operation showed no significant difference(P>0.05); One day after operation, the level of serum ET-1 of OP group was significantly higher than that of PVP group (P<0.01),and 2d after operation, the level of serum ET-1 of OP group was still significantly higher than that of PVP group (P<0.01). The levels of ET-1 of NON-CHD group before operation showed no significant difference(P>0.05); 1d after operation, the level of serum ET-1 of OP group was significantly higher than that of PVP group (P<0.01),and 2d after operation, the level of serum ET-1 of OP group was still significantly higher than that of PVP group(P<0.05)Conclusion1. the surgical trauma in patients who receive the treatment of PVP is slim .2. the treatment of PVP combined with TURP gatheres virtue of both sides,which is a reasonable selection for the patients with BPH. 3. the treatment of GreenlightPVP is safety to the patients with BPH,especially to those who are complicated with CHD.