基于经会阴多模态超声的女性压力性尿失禁模型的构建与预测价值  

Model construction and predictive value of female stress urinary incontinence based on transperineal multimodal ultrasound

作　　者：郭二芳 冯蕾[2] 石超会 林伟群 李宁 张树华 GUO Erfang;FENG Lei;SHI Chaohui;LIN Weiqun;LI Ning;ZHANG Shuhua(Department of Ultrasound,North China University of Science and Technology Affiliated Hospital,Hebei Province,Tangshan063000,China;Department of Ultrasound,the Fourth Medical Center of the Chinese People’s Liberation Army General Hospital,Beijing100142,China)

机构地区：[1]华北理工大学附属医院超声科,河北唐山063000 [2]解放军总医院第四医学中心超声科,北京100142

出　　处：《中国医药导报》2024年第19期150-154,共5页China Medical Herald

基　　金：河北省医学科学研究课题(20231265)。

摘　　要：目的基于经会阴多模态超声构建女性压力性尿失禁(SUI)的预测模型并评估其预测价值。方法选取2020年9月至2022年9月华北理工大学附属医院收治144例女性SUI患者为SUI组,同期92名健康体检女性为对照组。分析女性SUI发生的影响因素,评估经会阴多模态超声指标对女性SUI发生的预测价值。结果SUI组年龄高于非SUI组,差异有统计学意义(P<0.05)。SUI组膀胱颈下移距离、膀胱颈位置移动度、膀胱尿道后角(PUA)、肛提裂孔面积(LHA)、静息状态下耻骨直肠肌杨氏模量值(E_(1))高于非SUI组,最大缩肛状态下耻骨直肠肌杨氏模量值(E_(3))、最大缩肛状态下与静息状态下耻骨直肠肌杨氏模量值之差(ΔE)低于非SUI组,差异有统计学意义(P<0.05)。PUA、LHA、E_(1)、E_(3)、ΔE是女性SUI发生的影响因素(P<0.05),预测模型方程为:Logit(P)=0.151×PUA+0.602×LHA+0.814×E_(1)-0.154×E_(3)-0.147×ΔE-57.031。预测模型预测女性SUI发生的曲线下面积高于PUA、LHA、E_(1)、E_(3)、ΔE单独预测。结论经会阴多模态超声可以清晰、直观地反映女性SUI患者盆底结构的解剖及功能变化;预测模型的预测价值更高。Objective To construct predictive model of female stress urinary incontinence(SUI)based on transperineal multimodal ultrasound,and to evaluate its predictive value.Methods A total of 144 female patients with SUI admitted to North China University of Science and Technology Affiliated Hospital from September 2020 to September 2022 as SUI group,and 92 healthy women underwent physical examination during the same period as non-SUI group.The influencing factors for occurrence of female SUI were analyzed,the predictive value of transperineal multimodal ultrasound indexes for the occurrence of female SUI were assessed.Results The age of SUI group was higher than that of non-SUI group,the difference was statistically significant(P<0.05).The bladder neck downward distance,bladder neck descent,posterior urethrovesical angle(PUA),levator hiatal area(LHA),and the puborectal Young’s modulus value at rest(E_(1))of SUI group were higher than those of non-SUI group,and the puborectal Young’s modulus value at maximal retraction(E_(3)),and the difference of puborectal Young’s modulus value at maximal retraction and at rest(ΔE)were lower than those of non-SUI group,the differences were statistically significant(P<0.05).PUA,LHA,E_(1),E_(3),ΔE were the influencing factors for occurrence of female SUI(P<0.05),and the prediction model equation was as follows:Logit(P)=0.151×PUA+0.602×LHA+0.814×E_(1)-0.154×E_(3)-0.147×ΔE-57.031.The area under the curve predicted by the prediction model was higher than that predicted by PUA,LHA,E_(1),E_(3),andΔE alone.Conclusion Transperineal multimodal ultrasound can clearly and intuitively reflect the anatomical and functional changes of pelvic floor structures in female patients with SUI;the predictive value of the predictive model is higher.

关 键 词：经会阴多模态超声 压力性尿失禁 肛提裂孔 

分 类 号：R445.1[医药卫生—影像医学与核医学]