前列腺突入膀胱程度及尿TIMP-2水平与前列腺增生患者膀胱出口梗阻严重程度的相关性分析  

Correlation analysis of degree of intravesical prostatic protrusion(IPP)and tissue inhibitor of metalloproteinase-2(TIMP-2)level with severity of bladder outlet obstruction(BOO)in patients with benign prostatic hyperplasia(BPH)

作　　者：张运伟 李殷南 沈伟 朱文尧 夏志忠 ZHANG Yunwei;LI Yinnan;SHEN Wei;ZHU Wenyao;XIA Zhizhong(Department of Urology,Chongming Hospital Affiliated to Shanghai University of Health Sciences,Shanghai 202150,China;Department of Urology,Third People's Hospital of Bengbu,Bengbu Anhui 233099,China)

机构地区：[1]上海健康医学院附属崇明医院泌尿外科,上海202150 [2]蚌埠市第三人民医院泌尿外科,安徽蚌埠233099

出　　处：《新疆医科大学学报》2024年第2期249-253,共5页Journal of Xinjiang Medical University

基　　金：上海市崇明区“可持续发展科技创新行动计划”项目(CKY2023-28)。

摘　　要：目的研究前列腺突入膀胱程度(Intravesical prostatic protrusion,IPP)及尿金属蛋白酶组织抑制剂-2(Tissue inhibitor of metalloproteinase-2,TIMP-2)与前列腺增生患者膀胱出口梗阻(Bladder outlet obstruction,BOO)严重程度的相关性。方法收集99例良性前列腺增生(Benign prostatic hyperplasia,BPH)患者纳入本研究,收集患者临床资料,检测患者IPP及尿TIMP-2,对患者进行尿动力学检测。根据国际前列腺症状评分(International prostate symptom score,IPSS)将患者分为3组,0~7评分为轻度组,共42例,8~19分为中度组,共25例,20~35分为重度组,共32例。采用Logistic回归分析3组患者的临床资料、IPP、尿TIMP-2、膀胱出口梗阻指数(Bladder outlet obstruction,BOOI)的相关性。采用受试者工作特征曲线(Receiver operating characteristic,ROC)分析IPP、TIMP-2检测预测BOO的敏感性。结果使用单因素方差分析法分析3组患者的临床指标,随着患病程度加重,年龄、TPV、IPSS、IPP、尿TIMP-2水平均有增加趋势,尿动力学指标中Qmax下降,Pdet.Qmax、BOOI、PVR均升高,且差异具有统计学意义(P均<0.05)。相关性分析结果显示,3组患者BOOI与年龄、BMI、TPV、PVR无显著相关性(P均>0.05)。轻度组、中度组和重度组患者BOOI与IPP、尿TIMP-2以及IPSS均呈正相关(P均<0.05)。ROC曲线分析显示IPP与尿TIMP-2单独预测BOO均具有较强敏感性,IPP联合尿TIMP-2检测敏感性更高(P均<0.05)。结论IPP、尿TIMP-2与前列腺增生患者BOO严重程度具有相关性,且IPP联合尿TIMP-2预测BOO具有较高敏感性。Objective To study the correlation between intravesical prostatic protrusion(IPP)and tissue inhibitor of metalloproteinase-2(TIMP-2)with the severity of bladder outlet obstruction(BOO)in patients with benign prostatic hyperplasia(BPH).Methods 99 patients with BPH were included in the study.Clinical data was collected,and IPP and urine TIMP-2 were measured.Urodynamic testing was performed on the patients.According to the International Prostate Symptom Score(IPSS),the patients were divided into 3 groups:mild(0-7 score,42 patients),moderate(8-19 score,25 patients),and severe(20-35 score,32 patients).Logistic regression analysis was used to determine the correlation between the clinical data,IPP,urine TIMP-2 and bladder outlet obstruction index(BOOI)of the 3 groups of the patients.Receiver operating characteristic(ROC)curve analysis was used to assess the sensitivity of IPP and TIMP-2 in predicting BOO.Results Analysis using one-way analysis of variance showed that with increasing disease severity,age,TPV,IPSS,IPP and urine TIMP-2 levels all tended to increase,while urodynamic parameters such as Qmax was decreased,Pdet.Qmax,BOOI and PVR was increased,and the differences were statistically significant(all P<0.05).The correlation analysis results showed that BOOI in the 3 groups of the patients had no significant correlation with age,BMI,TPV and PVR(all P>0.05).BOOI in the mild,moderate and severe groups of the patients were positively correlated with IPP,urine TIMP-2 and IPSS(all P<0.05).ROC curve analysis showed that IPP and urine TIMP-2 independently had strong sensitivity in predicting BOO,and the sensitivity was higher with combined IPP and urine TIMP-2 testing(all P<0.05).Conclusion IPP and urine TIMP-2 was correlated with the severity of BOO in patients with BPH,and the combination of IPP and urine TIMP-2 has higher sensitivity in predicting BOO.

关 键 词：前列腺突入膀胱程度 尿TIMP-2 良性前列腺增生 膀胱出口梗阻 

分 类 号：R697.3[医药卫生—泌尿科学]