间质性膀胱炎/膀胱疼痛综合征尿动力学检查价值分析  

Analysis of the value of urodynamic examination in interstitial cystitis/bladder pain syndrome

作　　者：昂小杰 蒋昱枫[1] 张林 蔡宗强[1] 欧阳骏[1] 黄玉华[1] 陈卫国[1] ANG Xiaojie;JIANG Yufeng;ZHANG Lin;CAI Zongqiang;OUYANG Jun;HUANG Yuhua;CHEN Weiguo(Department of Urology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院泌尿外科,江苏苏州215006

出　　处：《临床泌尿外科杂志》2021年第1期24-27,33,共5页Journal of Clinical Urology

基　　金：江苏省医学重点学科(No:ZDXKA2016012)。

摘　　要：目的:探讨间质性膀胱炎/膀胱疼痛综合征(interstitial cystitis/bladder pain syndrome,IC/BPS)尿动力学特征及鉴别诊断价值。方法:回顾性分析2019年06月—2019年12月就诊于我院40例女性IC/BPS患者与40例女性单纯压力性尿失禁(stress urinary incontinence,SUI)患者的尿动力学检查结果,比较两组各项指标有无差异,并利用ROC曲线分析相关指标诊断价值。结果:两组患者年龄、BMI、是否绝经、阴道分娩次数及盆腔手术史比较差异无统计学意义(P>0.05);而两组患者初始尿意容量[(99.20±28.42)mL vs.(168.20±31.09)mL]、强烈尿意容量[(159.55±46.26)mL vs.(260.58±54.96)mL]、急迫尿意容量[(197.95±60.92)mL vs.(332.40±48.91)mL]、最大膀胱容量[(202.00±56.53)mL vs.(357.20±54.39)mL]、膀胱顺应性[(19.85±10.08)mL/cmH2O vs.(48.75±16.53)mL/cmH2O]、最大尿流率[(10.15±3.20)mL/s vs.(17.50±5.77)mL/s]、排尿初始膀胱压[(33.67±7.69)cmH2O vs.(26.28±23.02)cmH2O]、最大尿流率时逼尿肌压[(49.54±17.26)cmH2O vs.(29.05±12.92)cmH2O]、膀胱出口梗阻系数[(29.24±17.79)vs.(-5.95±15.45)]、最大逼尿肌压[(80.95±35.53)cmH2O vs.(58.08±27.68)cmH2O]及残余尿[(21.43±19.72)mL vs.(2.00±6.08)mL]比较差异均有统计学意义(P<0.01)。ROC曲线提示当初始尿意膀胱容量为125.5 mL、膀胱出口梗阻系数为10.15时,其诊断意义最大。结论:女性IC/BPS患者相较单纯压力性尿失禁患者表现为膀胱敏感度增加以及顺应性下降,呈功能性膀胱出口梗阻,对于鉴别诊断有一定临床意义。Objective:To investigate the urodynamic characteristics and differential diagnosis of female patients with interstitial cystitis/bladder pain syndrome(IC/BPS).Methods:A retrospective analysis of the urodynamic test results of 40 female IC/BPS patients and 40 female patients with simple stress urinary incontinence in our hospital from June 2019 to December 2019.The difference of various indexes between the two groups were compared,and the diagnostic value of related indexes was analyzed by ROC curve.Results:There was no significant difference between the two groups of patients in age,BMI,menopause,the number of vaginal deliveries or the history of pelvic surgery.The mean initial urinary volume,intense urinary capacity,urgent urinary capacity,maximum bladder capacity,bladder compliance,maximum urinary flow rate,initial bladder pressure,detrusor pressure at maximum flow rate,bladder outlet obstruction coefficient,maximum detrusor pressure and residual urine volume of the two groups were(99.20±28.42)mL vs.(168.20±31.09)mL,(159.55±46.26)mL vs.(260.58±54.96)mL,(197.95±60.92)mL vs.(332.40±48.91)mL,(202.00±56.53)mL vs.(357.20±54.39)mL,(19.85±10.08)mL/cmH2O vs.(48.75±16.53)mL/cmH2O,(10.15±3.20)mL/s vs.(17.50±5.77)mL/s,(33.67±7.69)cmH2O vs.(26.28±23.02)cmH2O,(49.54±17.26)cmH2O vs.(29.05±12.92)cmH2O,(29.24±17.79)vs.(-5.95±15.45),(80.95±35.53)cmH2O vs.(58.08±27.68)cmH2O and(21.43±19.72)mL vs.(2.00±6.08)mL,respectively.The P values of each index were all less than 0.01,so there was significant difference.ROC curve showed that the differential diagnosis was most significant when the threshold of initial urinary bladder capacity was 125.5 mL and the cutoff value of bladder outlet obstruction coefficient was 10.15.Conclusion:The bladder compliance of female patients with IC/BPS decreased,showing functional bladder outlet obstruction,and there was no characteristic change of urinary movement,but it had certain clinical significance for differential diagnosis.

关 键 词：间质性膀胱炎 膀胱疼痛综合征 尿流动力学 诊断 

分 类 号：R694[医药卫生—泌尿科学]