无创检测方法诊断良性前列腺增生患者膀胱出口梗阻  

Diagnosing bladder outlet obstruction among benign prostate hyperplasia patients by combination of noninvasive methods

作　　者：徐丁[1] 黄涛[1] 朱云开[2] 陈亚青[2] 齐隽[1] 

机构地区：[1]上海交通大学医学院附属新华医院泌尿外科,200092 [2]上海交通大学医学院附属新华医院超声科,200092

出　　处：《中华临床医师杂志（电子版）》2013年第8期81-83,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：上海市科学技术委员会科研计划项目(09411950100;1041195200);国家自然科学基金(81070600)

摘　　要：目的联合应用多种无创检测方法诊断良性前列腺增生患者膀胱出口梗阻。方法收集70例良性前列腺增生患者,所有患者均完成国际前列腺症状评分(IPSS),前列腺特异性抗原(PSA),经直肠前列腺超声[(包括前列腺体积(TPV),移行区体积(TZV),移行区指数(TZI),膀胱内前列腺突出(IPP)],尿流率检测以及尿流动力学检测。根据尿流动力学检测结果分为梗阻组与非梗阻组。结果梗阻组Qmax显著低于非梗阻组,TPV、TZV、TZI、IPP、Qmax与膀胱出口梗阻指数有显著相关性,通过多因素回归得到梗阻诊断模型:BDI=0.025×TPV-0.457×Qmax+3.611,ROC曲线下面积为0.876。结论 BDI结合了无创、简易、价格低廉的方法,在诊断和评估良性前列腺增生患者是否存在膀胱出口梗阻中有着一定的价值,能为临床医师的决策提供一定的帮助。Objective To diagnosing bladder outlet obstruction （BOO）among benign prostate hyperplasia （BPH） patients by combination of noninvasive methods. Methods The study involved 70 patients who visited our department with lower urinary tract symptom （LUTS） suggestive BPH. All the patients were evaluated with the International Prostate Symptom Score （ IPSS ）, serum prostate specific antigen （ PSA ） level, total prostate volume （TPV）, transitional zone volume （TZV）, transitional zone index（TZI）, intravesical prostatic protrusion （IPP）and urodynamic studies. The urodynamic results were used to divide patients into 2 groups with＇and without BOO. Results Qmax in the group with BOO was significantly lower than it in the group without BOO. TPV, TZV, TZI, IPP, Qmax were all significantly associated with BOOI, BOO diagnosing index was calculated by logistics regression： BDI = 0. 025 × TPV - 0. 457 × Qmax ＋ 3.611. AUC of BDI was 0. 876. Conclusion BDI could diagnose BOO w/th considerable accuracy, which could help doctors select treatment of BPH patients.

关 键 词：前列腺增生 膀胱出口梗阻 尿流率 前列腺体积 

分 类 号：R697.3[医药卫生—泌尿科学]