骶神经调节术治疗间质性膀胱炎二期转化率的影响因素及预测模型  

Influence factors and predictive model of the second stage conversion rate in the treatment of sacral neuromodulation of interstitial cystitis

作　　者：王佳文 马天明 孟令峰[1] 张威[1] 刘晓东 张耀光[1] WANG Jiawen;MA Tianming;MENG Lingfeng;ZHANG Wei;LIU Xiaodong;ZHANG Yaoguang(Department of Urology,Beijing Hospital,National Center of Gerontology,Beijing,100730,China)

机构地区：[1]北京医院泌尿外科国家老年医学中心,北京100730

出　　处：《临床泌尿外科杂志》2021年第3期178-181,共4页Journal of Clinical Urology

基　　金：国家重点研发计划(No:2018YFC2002202)。

摘　　要：目的:探讨可能影响间质性膀胱炎(interstitial cystitis,IC)患者骶神经调节术(sacral neuromodulation,SNM)二期转化的影响因素。建立IC患者SNM二期转化率的预测模型,为国内SNM患者的临床数据分析提供新的方法与思路。方法:回顾性分析2012年4月—2019年12月我院收治的43例行SNM的IC患者的临床资料,男6例,女37例,年龄33~79岁,平均56岁。所有患者均经过行为治疗、药物治疗以及至少一种推荐疗法治疗无效或效果不佳。43例均行SNM,依据二期植入与否分为未转化组与转化组,分析两组的年龄、日均排尿次数、术前焦虑评分等数据,运用ROC曲线与Logistic回归模型分析探讨影响IC患者接受二期永久植入术的因素,最后应用R软件建立其影响因素的预测模型。结果:一期体验植入术后15例患者因对疗效不满意拒绝行二期永久植入术,28例接受二期永久植入术治疗,本研究二期转化率为65%。研究结果显示年龄(P=0.025)、术前病程(P=0.042)、术前焦虑评分(P=0.008)对IC患者SNM的二期转化率具有预测价值,两组的日均排尿次数、日均夜尿次数、PUF评分以及生活质量评分比较差异无统计学意义。ROC曲线纳入年龄、术前病程和术前焦虑评分时的曲线下面积为0.852(P<0.001),提示该模型具有良好的预测价值。结论:年龄、术前病程及术前焦虑评分可能是IC患者SNM二期转化的影响因素。本研究建立的预测模型预测价值良好,IC患者可能从SNM术前的二期转化预测模型中获益,因此有必要扩大样本量、进行更多的前瞻性研究以验证本研究的结论。Objective: To explore the factors that may affect the secondary transformation of sacral neuromodulation(SNM) in patients with interstitial cystitis(IC). To establish the prediction model of SNM secondary conversion rate in patients with IC, and to provide new methods and ideas for clinical data analysis of SNM patients in China. Methods: The data of 43 patients with IC who underwent SNM from April 2012 to December 2019 in Beijing Hospital were analyzed retrospectively. There were 6 males and 37 females, aged 33-79 years, with an average age of 56 years. All patients were treated with behavioral therapy, medication, and at least one of the recommended therapies. Forty-three patients were divided into two groups according to whether the second stage implantation was performed or not. The age, the average number of micturition per day, the preoperative anxiety score and other data of the two groups were analyzed. The ROC curve and logistic regression model were used to analyze the factors influencing the second stage permanent implantation of IC patients. Finally, the prediction model of the influencing factors was established by R software. Results: Fifteen patients refused to accept the second stage permanent implantation because of the unsatisfactory effect after the first stage experience implantation, while 28 patients received the second stage permanent implantation. The second stage conversion rate of this study was 65%. The results showed that age(P=0.025), preoperative course(P=0.042) and preoperative anxiety score(P=0.008) had predictive value for SNM secondary conversion rate of IC patients. There was no significant statistical difference in the daily average urination times, daily average nocturia times, PUF scores and quality of life scores between the two groups. The area under the ROC curve was 0.852(P<0.001) when age, preoperative course and preoperative anxiety score were included in the ROC curve, suggesting that the model has a good predictive value. Conclusion: Age, preoperative course of diseas

关 键 词：间质性膀胱炎 骶神经调节术 临床预测模型 

分 类 号：R694[医药卫生—泌尿科学]