良性前列腺增生患者并发膀胱过度活动症与膀胱出口梗阻的关系  

Correlation between overactive bladder and bladder outlet obstruction in benign prostatic hyperplasia

作　　者：朱智能[1] 兰东阳[1] 王海鹏[1] 朱朝辉[1] 庞自力[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022

出　　处：《临床泌尿外科杂志》2013年第2期145-147,共3页Journal of Clinical Urology

摘　　要：目的:研究分析BPH患者并发膀胱过度活动症(OAB)与膀胱出口梗阻(BOO)程度的相关性。方法:163例BPH患者,根据OAB症状评分(OABSS)将患者进行严重程度分级:0级无尿急等OAB症状;OABSS为1级≤5分;2级6～11分;3级≥12分。经腹超声测定前列腺三径和前列腺突入膀胱的距离(IPP),尿动力学检查测定最大尿流率(Qmax)、剩余尿,最大尿流率时的逼尿肌压力(P&det@Qmax),并计算出AG值,进行方差分析和相关性分析检验。结果:按OAB症状严重程度分为四组:0级44例,1级35例,2级46例,3级38例。OAB症状程度轻重与患者年龄、前列腺体积、最大自由尿流率等无相关。IPSS评分随OAB症状加重而增高,0～3级分别为(8.4±4.2)、(12.7±3.8)、(15.6±3.6)、(18.5±4.1)分(F=49.931,P=0.000);前列腺中叶增生程度(IPP)呈现显著性升高趋势,0～3级分别为(0.4±0.3)、(0.8±0.5)、(1.1±0.7)、(1.3±0.6)cm(F=21.385,P=0.000);剩余尿量显著增多,0～3级分别为(50.6±36.1)、(64.5±29.0)、(68.3±30.8)、(72.7±39.2)ml(F=3.345,P=0.021);Pdet@Qmax显著增高,0～3级分别为(48.3土37.5)、(53.6±27.9)、(58.7±29.1)、(70.4±26.8)cmH2O(1cmH2O=0.098kPa,F=3.722,P=0.012)。BOO(AG>40)发生率分别为:0级36.4%(16/44)、1级54.3%(19/35)、2级58.7%(27/46)、3级73.7%(28/38),显示OAB症状与AG值呈正相关(r=0.263,P=0.001)。结论:BPH患者并发膀胱过度活动症与膀胱出口梗阻存在显著相关性。Objective：To analyze the relationship between overactive bladder（OAB） and bladder outlet obstruc- tion（BOO） in patients with benign prostatic hyperplasia（BPH）. Method：Total of 163 patients with BPH were di- vided into 4 severity degrees according to overactive bladder symptom score（OABSS）, such as Grade 0（no urgent urination） ; Grade 1（OABSS≤5） ; Grade 2（6-11）; Grade 3（OABSS≥12）. Prostate three diameters and the intra- vesical prostatic protrusion（IPP） was measured by transabdominal ultrasound. Urodynamic examination included maximum flow rate （Q_max） , P_det @ Q_max, residual urine volume （RUV） and AG value. For statistical analysis AVOVA（analysis of variance） and Spearman correlation were used. Result： In the 163 cases, the OABSS degrees were as follows ： Grade 0,44 cases; Grade 1,35 cases ; Grade 2,46 cases and Grade 3,38 cases. There were no sta- tistical significances in age,prostatic volume and Q As the degree of OABSS increased, IPSS increased （Grade 0 to 3： 8.4±4.2, 12.7±3.8, 15.6±3.6, 18.5±4. 1, respectively; F=49.931, P=0.000）; IPP increased （Grade 0 to 3： 0.4±0.3, 0.8±0.5, 1. 1±0.7, 1.3±0.6 cm, respectively; F=21. 385, P=0. 000） ; RUV in- creased （Grade 0 to 3： 50.6±36. 1, 64.5±29.0, 68. 3±30.8, 72.7±5.39.2 ml, respectively; F=3. 345, P=0. 021）; P_det@Q_max increased （Grade 0 to 3： 48.3±37.5, 53.6±27.9, 58.7±29.1, 70.4±26.8 cmH20, respectively; F=3. 722 ,P=0. 012）. It was also found that the OAB symptom was significantly correlated with AG value, bladder outlet obstruction （AG〉40） incidence increased （Grade 0 to 3： 36.4%, 54.3%, 58.7%, 73.7% r= 0. 263, P=0. 001）. Conclusion： There is a significant correlation between the OAB symptom and BOO in pa- tients with BPH.

关 键 词：良性前列腺增生 膀胱过度活动症 膀胱出口梗阻 

分 类 号：R697[医药卫生—泌尿科学]