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作 者:任衢军 成泽民[1] 杜义堂 曾东升[1] 黄超[1] 袁宗琳
机构地区:[1]达州市中心医院泌尿外科,四川达州635000
出 处:《医学综述》2015年第24期4590-4592,共3页Medical Recapitulate
摘 要:目的探讨最大自由尿流率(Qmax)与残余尿联合评估膀胱出口梗阻致逼尿肌损伤的价值。方法选择在2011年7月至2014年2月在达州市中心医院就诊的经尿动力学压力-流率测定(IPFS)确诊的膀胱出口梗阻的良性前列腺增生(BPH)患者126例,根据IPFS结果分为逼尿肌损伤组(48例)和无损伤组(78例)。比较两组患者的Qmax和残余尿,应用Logistics回归分析建立逼尿肌损伤诊断指数(DDI)模型,采用受试者工作特征(ROC)曲线评价DDI、Qmax、残余尿诊断逼尿肌损伤的效率。结果损伤组患者的Qmax显著低于无损伤组[(9.2±2.8)m L/s比(10.5±3.1)m L/s,t=2.370,P<0.05],残余尿显著高于无损伤组[(62.7±13.6)m L比(40.5±15.4)m L,t=2.992,P<0.05],通过Logistic回归分析得到逼尿肌损伤诊断指数模型DDI=0.127×残余尿-0.516×Qmax+3.268。以DDI、Qmax、残余尿诊断逼尿肌损伤的灵敏度和特异度分别为89.6%、72.9%、47.9%和83.3%、46.2%、76.9%,ROC曲线下面积(AUC)分别为0.862、0.579和0.685。结论DDI能较准确地诊断膀胱出口梗阻患者的逼尿肌损伤,为临床医师的决策提供参考。Objective To investigate the function of maximal free urinary flow( Qmax) combined with residual urine( PVR) in assessing bladder outlet obstruction caused by urination disorder. Methods Total of 126 benign prostate hyperplasia patients with bladder outlet obstruction diagnosed by invasive pressure flow studies( IPFS) in Dazhou Central Hospital from Jul. 2011 to Feb. 2014 were selected,and then divided into detrusor injury group( 48 cases) and non-injury group( 78 cases) according to IPFS results. Qmaxand PVR were measured,detrusor diagnostic index( DDI) was calculated by logistics regression,then the diagnosing efficiency of DDI,Qmax,PVR were evaluated by ROC. Results Compared with the non-injury group,patients in the injury group had lower level of Qmax [( 9. 2 ± 2. 8) m L / s vs( 10. 5 ± 3. 1) m L / s,t =2. 370,P 0. 05] and higher level of PVR [( 62. 7 ± 13. 6) m L vs( 40. 5 ± 15. 4) m L,t = 2. 992,P 0. 05]. According to the logistics regression analysis,DDI = 0. 127 × PVR- 0. 516 × Qmax+ 3. 268. The sensitivity and specificity of DDI,Qmax,PVR in diagnosing detrusor damage of bladder outlet obstruction patients were 89. 6%,72. 9%,47. 9% and 83. 3%,46. 2%,76. 9%,and the area under ROC( AUC) was0. 862,0. 579,0. 685 respectively. Conclusion DDI can diagnose detrusor injury of bladder outlet obstruction patients accurately,which can provide reference for the doctors to select treatments.
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