前列腺增生患者逼尿肌收缩曲线下面积相关参数与膀胱出口梗阻的关系

目的 分析逼尿肌收缩曲线下面积相关参数与BOO的关系,探讨逼尿肌收缩曲线下面积相关参数用于诊断BOO的可行性. 方法 2006年10月至2008年10月对138例BPH患者行尿动力学检查,通过AG数和直线被动尿道阻力关系(Lin-PURR)将患者分为无梗阻、可疑梗阻和梗阻3组.计算排尿时逼尿肌收缩曲线下面积(AUCdet)、排尿时逼尿肌收缩曲线下面积与排尿量的比值(AUCdet/Vol),并与AG数和Lin-PURR做相关性检验,使用线性区别分析方法 对AUCdet/Vol 关于无梗阻、可疑梗阻和梗阻的分类与传统方法 进行比较. 结果 AUCdet、AUCdet/Vol与AG数、Lin-PURR具有很好的相关性(均P＜0.001).109例患者根据AG数和Lin-PURR进入下一步分析,其中无梗阻33例、可疑梗阻32例、梗阻44例.3组患者AUCdet分别为(766±354)、(1214±800)、(2294±1166)cm H2O·s,AUCdet/Vol分别为(5.47±2.26)、(9.65±4.94)、(20.03±10.86)crn H2O·s/ml,组间比较差异均有统计学意义(均P＜0.001).AUCdet/Vol诊断BOO与传统分组方法 的总符合率为68.8%(75/109),其中诊断无梗阻、可疑梗阻和梗阻的符合率分别为90.9%(30/33)、43.8%(14/32)和70.5%(31/44). 结论 应用逼尿肌收缩曲线下面积相关参数可以很好地反映BOO情况.

Relationship between the bladder outlet obstruction and the area under the curve of detrusor during voiding related parameters

Objective To study the relationship between the bladder outlet obstruction(BOO)and the area under the curve of detrusor during voiding related parameters. Methods One hundred and thirty-eight patiens with benign prostate hyperplasia(BPH) underwent clinical evaluation, including physical examination, flow rate and post-void residual volume measurement. Pressure flow studies were performed. Mean patient age was 68 years (range 56 to 82). The AG number and the LinPURR were recorded to classify the patients into 3 groups, namely unobstructed, equivocal obstructed and obstructed, as the traditional classification. Two new parameters including the area under the curve of detrusor pressure during voiding(AUCdet) and the area under the curve of detrusor pressure during voiding adjusted for voided volume(AUCdet/Vol) were calculated and compared with the traditional classification using the Linear discriminant analysis. Results According to the traditional classification, there were 33 unobstructed, 32 equivocal and 44 obstructed cases. The AUCdet and AUCder/Vol of the 3 groups were different(P＜0.001). Linear discriminant analysis showed that of the cases, 90. 9%(30/33), 43.8%(14/32) and 70. 5%(31/44) were identically categorized by the traditional and the AUCdet/Vol classifications in the unobstructed, equivocal and obstructed groups, respectively. Conclusions The area under the curve of detrusor pressure during voiding related parameters appear to be good parameters of the BOO in patients with BPH. Further studies are needed to test the reliability and validity of these new parameters.