2 s时尿流率鉴别膀胱出口梗阻与逼尿肌收缩无力的相关性  

Analysis of the correlation between 2-second urine flow rate and differentiation of bladder outlet obstruction and detrusor underactivity

作　　者：赵昊哲 张少华 孙新惠[2] 文建国[3] 窦启锋[1] ZHAO Haozhe;ZHANG Shaohua;SUN Xinhui;WEN Jianguo;DOU Qifeng(Department of Urology,The First Affiliated Hospital of Xinxiang Medical University,Xinziang 453100,Henan,China;Urodynamic Examination Room,The First Affiliated Hospital of Xinxiang Medical University,Xinriang 4531o0,Henan,China;The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]新乡医学院第一附属医院泌尿外科,河南新乡453100 [2]新乡医学院第一附属医院尿动力检查室,河南新乡453100 [3]郑州大学第一附属医院,河南郑州450052

出　　处：《西部医学》2025年第2期243-246,251,共5页Medical Journal of West China

基　　金：国家自然科学基金资助项目(U1904208);新乡市科学技术局-新乡医学院第一附属医院灾后重建科技专项项目(21CJ002)。

摘　　要：目的 探讨2 s时尿流率评估膀胱出口梗阻(BOO)与逼尿肌收缩无力(DU)的鉴别价值。方法 选择2023年1月—2024年3月于新乡医学院第一附属医院就诊的下尿路症状(LUTS)患者74例。经尿动力学压力-流率同步测定(PFS)后,根据尿动力学检查结果分为BOO组(42例)和DU组(32例)。比较两组患者尿流率参数及可能的影响因素。经过t检验多因素筛选后,选取其中有意义的指标进行Logistic回归分析,包括受试者工作特征(ROC)曲线,分析评价该指标效率。结果 BOO组与DU组最大尿流率(Qmax)、平均尿流率(Qave)、2 s时尿流率、尿量比较,差异有统计学意义(P<0.05);DU组2 s时尿流率较BOO组高(P<0.001)。经Logistic回归分析表明,2 s时尿流率[OR=1.428,95%CI=1.031~1.997,P=0.032]是区分BOO和DU的独立预测因子。单变量预测DU时,ROC曲线结果表明,2 s时尿流率的ROC曲线下面积(0.752)高于尿量(0.641)、最大尿流率(0.720)和平均尿流率(0.696)。结论 2 s时尿流率作为一种新的预测指标,能够在LUTS症状的男性患者中区分DU和BOO。Objective To explore the differential diagnostic value of the 2-second flow rate in assessing bladder outlet obstruction(BOO) and detrusor underactivity(DU).Methods Seventy-four patients with lower urinary tract symptoms(LUTS) who visited the First Affiliated Hospital of Xinxiang Medical University from January 2023 to March 2024 were selected.After undergoing pressure-flow study(PFS),the patients were divided into two groups based on urodynamic test results:42 male patients with confirmed BOO and 32 male patients with confirmed DU.The flow rate parameters and potential influencing factors of the two groups were compared.Significant indicators were selected for Logistic regression analysis,including the receiver operating characteristic(ROC) curve,to evaluate the efficiency of the indicator.Results There were statistically significant differences(P<0.05) in maximum flow rate,average flow rate,2-second flow rate,and urine volume between the BOO and DU groups;the 2-second flow rate of the BOO group was lower(1.70 mL/s vs 2.59 mL/s,P<0.001).Logistic regression analysis showed that the 2-second flow rate(Exp(B)=1.461,P<0.05) had a significant discriminative effect on the diagnosis of DU and BOO.In the univariate diagnosis of DU,the area under the ROC curve(AUC) for the 2-second flow rate(0.752) was higher than that for urine volume(0.641),maximum flow rate(0.720),and average flow rate(0.696).Conclusion The 2-second flow rate,as a new predictive indicator,can differentiate DU and BOO in male patients with LUTS symptoms.

关 键 词：下尿路症状 膀胱出口梗阻 尿动力学 尿流率 

分 类 号：R694[医药卫生—泌尿科学]