静态尿道压力图对良性前列腺增生所致膀胱出口梗阻的诊断价值  

Role of resting urethral pressure profile in diagnosing bladder outlet obstruction due to benign prostatic hyperplasia

作　　者：杨星亮[1] 赵江[1] 冯观贵 于伟[1] 李龙坤[1] 

机构地区：[1]第三军医大学新桥医院泌尿外科,重庆400038

出　　处：《第三军医大学学报》2014年第8期821-824,共4页Journal of Third Military Medical University

摘　　要：目的探讨静态尿道压力图(resting urethral pressure profile,RUPP)在评价良性前列腺增生(benign prostatic hyperplasiat,BPH)所致的膀胱出口梗阻中的诊断价值。方法回顾性分析2011年8月至2013年8月内我院收治的119例BPH患者的尿动力学资料,依据压力流率同步测定结果分别分为无梗阻组、可疑梗阻组、梗阻组。分别比较3组间RUPP指标的差异,并通过多因素Logistic回归分析建立函数模型,运用受试者工作曲线(ROC曲线)分析比较回归模型及各个指标诊断膀胱出口梗阻(bladder outlet obstruction,BOO)的价值。结果梗阻组的膀胱颈压、精阜压、前列腺长度、功能曲线长度、前列腺平台面积均显著大于无梗阻组,而最大尿道压和最大尿道闭合压组间则无统计学差异;多元Logistic回归分析中,前列腺平台面积和精阜压进入模型,经ROC曲线比较,联合指标对于梗阻的诊断价值明显高于其他指标(AUC为0.968),而单一指标中则以前列腺平台面积(prostatic plateau area,PPA)的ROC曲线下面积最具诊断价值(AUC为0.893)。结论 RUPP参数可用于诊断BPH所致膀胱出口梗阻,且特别适用于不能进行压力-流率测定(pressure-uroflow studies,P/Q)患者尿道梗阻情况的评价,参数中回归模型的诊断效力最佳。Objective To investigate the value of resting urethral pressure profile （RUPP） in the diagnosis of bladder outlet obstruction （BOO） due to benign prostatic hyperplasiat （BPH）. Methods Urodynamic and clinical data of 119 patients with BPH between August 2011 and August 2013 in our department were analyzed retrospectively. According to pressure-uroflow study （P/Q） , patients were divided into 3 groups： obstructed, equivocal obstructed and unobstructed, and the parameters of RUPP among different groups were compared. Multivariate logistic regression analysis was used to establish a regression model. Meanwhile, the Receiver operating characteristic （ROC） curves were used to investigate the value of different RUPP index and the regression model in assessing BOO due to BPH. Results Most parameters on RUPP in the obstructed group were significantly higher than those in the unobstructed group, such as prostatic length, functional profile length, pressure of bladder neck, pressure of seminal colliculus and prostatic plateau area （PPA） , except for maximum urethral pressure and maximum urethral closure pressure. The ROC curve exhibited that the regression model that combined PPA and pressure of seminal colliculus showed the best diagnostic value in all RUPP parameters （ the area under ROC curve was 0. 968 ）. In the individual parameters, PPA had the largest area under the ROC curve （AUC = 0.893）, showing better diagnostic power. Conclusion RUPP parameters can be used to evaluate the grade of obstruction due to BPH when the patients failed to be examined by P/Q. Among all the parameters the regression model is the best one for diagnosis.

关 键 词：静态尿道压力测定 良性前列腺增生 膀胱出口梗阻 诊断 

分 类 号：R443.8[医药卫生—诊断学] R694.2[医药卫生—临床医学]