良性前列腺增生患者残余尿量过多的影响因素及诊断模型  

Influencing factors and diagnostic model of excessive residual urine volume in patients with benign prostatic hyperplasia

作　　者：李宝赢 汤翰 国文豪 吕璞 陆永辉[1] LI Baoying;TANG Han;GUO Wenhao;LYU Pu;LU Yonghui(Department of Acupuncture and Moxibustion,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院西苑医院针灸科,北京市100091 [2]北京中医药大学研究生院,北京市100029

出　　处：《广西医学》2023年第3期272-276,共5页Guangxi Medical Journal

基　　金：中国中医科学院科技创新工程课题(CI2021A03514);北京市科技计划课题(Z191100006619055)。

摘　　要：目的探讨良性前列腺增生(BPH)患者残余尿量过多的影响因素并构建诊断模型。方法根据残余尿量将60例BPH患者分为残余尿量<20 mL组28例与残余尿量≥20 mL组32例。比较两组患者的年龄、BPH病程、前列腺体积、最大尿流率、排尿次数、国际前列腺症状评分(排尿不尽感得分、2 h内排尿得分、排尿间断性得分、排尿不能等待得分、尿线变细得分、排尿用力得分、夜尿次数得分)、小腹胀满得分、尿急程度得分。采用多因素Logistic回归模型分析BPH患者残余尿量过多的影响因素。基于获得的影响因素构建诊断模型,采用混淆矩阵计算模型计算总体诊断正确率,采用Hosmer-Lemeshow检验评价拟合度。结果两组患者的前列腺体积、最大尿流率、排尿次数、排尿不尽感得分、2 h内排尿得分、排尿间断性得分、排尿不能等待得分、尿线变细得分、夜尿次数得分、小腹胀满得分、尿急程度得分比较,差异均具有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,最大尿流率、排尿间断性得分、小腹胀满得分为BPH患者残余尿量过多的影响因素(均P<0.05)。构建诊断模型:Logit(P)=2.617-2.352×最大尿流率-1.997×排尿间断性得分-1.693×小腹胀满得分。诊断模型的总体诊断正确率为83.3%,拟合度良好(Hosmer-Lemeshow检验显示P>0.05)。结论最大尿流率、排尿间断性得分、小腹胀满得分均为BPH患者残余尿量过多的影响因素。通过上述3个指标构建的BPH患者残余尿量过多的诊断模型的总体诊断正确率较高,拟合度良好。Objective To explore the influencing factors of excessive residual urine volume in patients with benign prostatic hyperplasia(BPH),and to construct a diagnostic model.Methods A total of 60 BPH patients were assigned to residual urine volume<20 mL group(28 cases)or residual urine volume≥20 mL group(32 cases)according to residual urine volume.Patients′ages,disease courses of BPH,prostate volume,maximum urine flow rate,urination frequency,International Prostate Symptom Score with respect to scores of dripping of urine,urination within 2 hours,intermittent urination,urination without waiting,urine line thinning,urination force,nocturnal frequency,and lower abdomen distension score,urination urgency score were compared between the two groups.The influencing factors for excessive residual urine volume in BPH patients were analyzed by the multivariate Logistic regression model.The diagnostic model was constructed based on influencing factors obtained.The overall diagnostic accuracy was calculated by the confusion matrix calculation model,and the degree of fitting of the model was evaluated by the Hosmer-Lemeshow test.Results There were statistically significant differences in prostate volume,maximum urine flow rate,urination frequency,and scores of dripping of urine,urination within 2 hours,intermittent urination,urination without waiting,urine line thinning,nocturnal frequency,as well as lower abdomen distension score,urination urgency score between the two groups(all P<0.05).The results of Logistic regression analysis interpreted that the maximum urine flow rate,intermittent urination score,and lower abdomen distension score were the influencing factors for excessive residual urine volume in patients with BPH(all P<0.05).The diagnostic model was constructed as Logit(P)=2.617-2.352×the maximum urine flow rate-1.997×intermittent urination score-1.693×lower abdomen distension score.The overall diagnostic accuracy of diagnostic model was 83.3%,and the degree of fitting was favorable(with indication of Hosmer-Lemesh

关 键 词：良性前列腺增生 残余尿量 最大尿流率 国际前列腺症状评分 小腹胀满评分 诊断模型 

分 类 号：R697.3[医药卫生—泌尿科学]