糖尿病膀胱病变合并前列腺增生症患者的尿动力学变化及临床意义  

Urodynamic Changes in Diabetic Cystopathy Patients with Benign Prostatic Hyperplasia and Its Clinical Significance

作　　者：顾鑫[1] 王岸迪 薛秀荣[1] 景立伟[1] 李永禄[1] 王元松[1] 

机构地区：[1]河北省沧州中西医结合医院泌尿外科,河北沧州061001

出　　处：《医学综述》2016年第14期2849-2852,共4页Medical Recapitulate

摘　　要：目的探讨糖尿病膀胱病变(DCP)合并良性前列腺增生症(BPH)患者的尿动力学变化及临床意义。方法将2012年4月至2015年4月河北省沧州中西医结合医院收治的98例糖尿病合并BPH患者作为研究对象,按是否合并膀胱病变分为单纯糖尿病合并BPH组(57例)和DCP合并BPH组(41例),比较两组患者的国际前列腺症状评分(IPSS)、膀胱功能障碍情况、尿动力学检查结果[膀胱最大容积(MCC)、初始尿意容量(FDV)、膀胱顺应性(BC)、最大尿流率时逼尿肌压力(Pdet Qmax)、最大尿流率(Qmax)、残余尿量(PVR)]。结果 DCP合并BPH组IPSS中排尿不尽、尿频、尿中断、延迟排尿、排尿无力、夜尿次数以及症状总得分均高于单纯糖尿病合并BPH组[(4.8±0.4)分比(3.7±0.3)分,(4.7±0.5)分比(3.7±0.4)分,(3.3±0.2)分比(3.1±0.2)分,(3.8±0.3)分比(2.9±0.1)分,(3.1±0.4)分比(2.2±0.2)分,(3.9±0.3)分比(3.8±0.2)分,(28.3±3.7)分比(23.9±2.4)分],差异有统计学意义(P<0.05或P<0.01);尿流变细得分高于单纯糖尿病合并BPH组[(4.7±0.5)分比(4.6±0.4)分],差异无统计学意义(P>0.05)。DCP合并BPH组不稳定膀胱、低顺应性膀胱以及膀胱感觉减退发生率均高于单纯糖尿病合并BPH组[58.5%(24/41)比35.1%(20/57),36.6%(15/41)比17.5%(10/57),61.0%(25/41)比33.3%(19/57)],差异有统计学意义(P<0.05或P<0.01)。两组患者的尿动力学检查结果,DCP合并BPH组MCC、BC、Pdet Qmax与单纯BPH组比较差异无统计学意义(P>0.05);FDV、PVR较单纯糖尿病合并BPH组升高[(203.5±15.7)m L比(149.5±10.4)m L,(148.6±10.6)m L比(74.6±5.3)m L],Qmax较单纯糖尿病合并BPH组降低[(3.6±0.4)m L比(6.1±0.6)m L],差异有统计学意义(P<0.01)。结论DCP并BPH患者FDV、PVR显著升高,膀胱功能障碍发生率也显著升高,可见尿动力学检查能够为DCP合并BPH患者临床分期和治疗方案的选择提供指导作用。Objective To explore urodynamic of patients with diabetic cystopathy （DCP） complicated with benign prostatic hyperplasia （BPH） and its clinical significance. Methods A total of 98 diabetic patients with BPH in Hebei province Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine from Apr. 2012 to Apr. 2015 were included as research objects, according to the existence of bladder disease they were divided into pure diabetes mellitus complicated with BPH group of 57 cases and DCP complicated with BPH group of 41 cases,the International Prostate Symptom Score, bladder dysfunction, the urodynamic results[ maximum cystometric capacity （ MCC ）, first desire to void （ FDV ）, bladder compli- mace（BC） ,maximum flow rate of the detrnsor pressure （ Pdet Qmax ） , maximum urinary flow rate （ Qmax ） , residual urine volume （PVR） ] of the two groups were compared. Results The dribbling urine, frequent uri- nation, urinary interruption, delayed urination, inability to urinate, nocturia and total symptom scores defined in IPSS of DCP complicated with BPH group were higher than the pure diabetes mellitus complicated with BPH group [（4.8 ±0.4）points vs （3.7 ±0.3） points,（4.7 ±0.5） points vs （3.7 ±0.4） points, （ 3.3 ± 0. 2） points vs （3.1 ± 0.2） points, （3.8 ± 0. 3 ） points vs （2. 9 ± 0. 1 ） points, （3.1 ± 0. 4） points vs （2.2± 0.2） points, （3.9±0.3） points vs （3.8±0.2） points, （28.3 ± 3.7） points vs （23.9± 2. 4） points] ,the differ,±nces were statistically significant （P 〈0. 05 or P 〈0. 01 ） ; flow thinning score was higher than pure diabetes mellitus complicated with BPH group [ （ 4.7 ± 0.5 ） points vs （ 4.6 ± 0.4 ） points] , the difference was n.at statistically significant（ P 〉 0.05 ）. The bladder instability, low compliance bladder and bladder sensor） Joss of the DCP complicated with BPH group were higher than pure diabetes mcllitus complicated with BPH group [ 58.5% （ 24/4

关 键 词：糖尿病膀胱病变 前列腺增生症 尿动力学变化 膀胱功能障碍 

分 类 号：R587.2[医药卫生—内分泌]