高龄前列腺增生患者膀胱结石的影响因素及其风险模型  

Influencing factors and risk models of bladder stones in elderly patients with benign prostatic hyperplasia

作　　者：张家铭[1] 罗康 ZHANG Jiaming;LUO Kang(Department of Urology,Jiangyou People's Hospital,Mianyang 621700,China)

机构地区：[1]江油市人民医院泌尿外科,四川绵阳621700

出　　处：《现代泌尿外科杂志》2022年第2期144-147,共4页Journal of Modern Urology

摘　　要：目的探讨高龄前列腺增生患者膀胱结石的影响因素及其风险模型。方法选取2019年10月-2020年10月江油市人民医院收治的100例高龄前列腺增生患者,根据是否发生膀胱结石,将患者分为无膀胱结石组68例和膀胱结石组32例。比较两组一般资料,然后进行单因素、多因素Logistic回归分析,再根据回归系数构建合适的风险模型评价系统,并绘制ROC曲线,评估其对高龄前列腺增生患者膀胱结石发生的预测价值。结果100例高龄BPH患者膀胱结石发生32例,无膀胱结石发68例。两组患者年龄、前列腺体积(TPV)、前列腺移行带体积(TZV)、前列腺突入膀胱程度(IPP)、剩余尿量(PVR)、最大尿流率(Qmax)、排尿量(VV)、膀胱出口梗阻指数(BOOI)、前列腺尿道角(PUA)差异具有统计学意义(P<0.05)。而体质指数(BMI)、储尿期症状评分、排尿期症状评分及IPSS总分、tPSA无统计学差异。对相关单因素进行Logistic多因素回归分析结果显示,年龄、TPV、TZV、IPP、PUA、Qmax是高龄前列腺增生患者膀胱结石发生的独立危险因素(OR>1,P<0.05)。根据上述危险因素构建风险模型,其预测膀胱结石发生的ROC曲线下面积为0.837(95%CI:0.772-0.934),以8.56分为最佳临界值,此时的敏感度和特异度分别为86.32%和81.24%,Hosmer-Lemeshow拟合优度检验r=4.3,P=0.468。结论年龄、TPV、TZV、IPP、PUA、Qmax是高龄前列腺增生患者膀胱结石发生的独立危险因素,并且经风险模型证实,其对于高龄前列腺增生患者膀胱结石发生具有较高预测价值。Objective To explore the influencing factors and risk models of bladder stones in elderly patients with benign prostatic hyperplasia(BPH).Methods A total of 100 elderly(BPH)patients admitted to our hospital from Oct.2019 to Oct.2020 were selected.According to whether bladder stones occurred,the patients were divided into a bladder stone free group with 68 cases and a bladder stone group with 32 cases.The general data of the two groups were compared,and then single-factor and multi-factor Logistic regression analysis were performed,an appropriate risk model evaluation system was constructed based on the regression coefficients,and ROC curve was drawn to evaluate its predictive value for predicting the occurrence of bladder stones.Results There were 32 cases of bladder stones in 100 elderly patients with BPH and 68 cases without bladder stones.The differences in age,TPV,TZV,IPP,PVR,Qmax,VV,BOOI,PUA between the two groups were statistically significant(P<0.05).There were no statistically significant differences in BMI,urinary storage symptom score,urinary symptom score,total IPSS score,and tPSA.Logistic multivariate regression analysis showed that age,TPV,TZV,IPP,PUA,Qmax were independent risk factors(OR>1,P<0.05).A risk model was constructed based on the above risk factors,and the area under the ROC curve for predicting the occurrence of bladder stones was 0.837(95%CI:0.772-0.934).The optimal cut-off value was 8.56.The sensitivity and specificity were 86.32%and 81.24%,respectively Hosmer-Lemeshow goodness-of-fit test showed r=4.3,P=0.468.Conclusion Age,TPV,TZV,IPP,PUA,Qmax are independent risk factors for the occurrence of bladder stones in elderly patients with benign prostatic hyperplasia,and the risk assessment prediction model has confirmed that they have a high predictive value for the occurrence of bladder stones in elderly patients with benign prostatic hyperplasia.

关 键 词：前列腺增生 膀胱结石 影响因素 Logistics分析 风险模型 

分 类 号：R697.3[医药卫生—泌尿科学]