良性前列腺增生并发急性尿潴留的危险因素预测以及临床意义

目的探讨影响良性前列腺增生（BPH）患者并发尿潴留（AUR）的相关因素及在指导临床治疗中的意义。方法收集436例BPH患者的临床资料，包括fPSA、tPSA、移行带容积（TZV）、剩余尿量、尿流率等，采用纵向多中心联合方法，选择12个可能对患者并发AUR产生影响的特征性因素以及治疗方式进行Logistic回归分析，计算患者的预测指数。436例患者分为高、中、低3个危险组，分析各组的主要危险参数及AUR的发生情况。结果Logistic回归分析显示，与BPH并发AuR相关的危险因素为患者年龄（RR=2．924，P=0．050）、IPSS评分（RR=2．675，P=0．007）、fPSA（RR=4．106，P=0．000）、TZV（RR=3．635，P=0．000）、最大尿流率（Qmax，RR=0．110，P=0．000）、剩余尿量（RR=5．311，P=0．000）、尿潴留病史（RR=4．518，P=0.000）以及药物治疗（RR=0．092，P=0．000）。发生AUR的高、中、低危险组患者AUR发生率分别为95．0％、65．3％、0，差异有统计学意义（x^2=273．04，P〈0．01）。结论BPH患者发生AUR的危险度不同，可以根据患者危险度实施个体化治疗方案。

Risk prediction of acute urinary retention in benign prostatic hyperplasia

Objective To investigate the risk factors correlated with acute urinary retention (AUR) in benign prostatic hyperplasia (BPH). Methods Longitudinal multi center investigation was employed. The clinical and follow-up data of 436 BPH patients were collected, including fPSA, tPSA, transitional zone volume(TZV) ,post void residual, etc. 12 possible clinical factors influencing the occurrence of AUR and medical schedule were selected. A multivariate analysis was performed in these patients by the computer's Logistic regression. A prognostic index based on the Logistic regression was constructed, by which patients could be classified to different hazard groups and to observe the different incidence rate of AUR. Results In Logistic regression, several characteristics showed significant influence on incidence of AUR in BPH, including age (RR = 2. 924, P = 0. 050), IPSS score (RR = 2. 675, P = 0.007), fPSA (RR = A. 106, P=0. 000), TZV (RR=3. 635, P = 0. 000), maximum flow rate (RR = 0. 110, P = 0.000), post void residual (RR = 5. 311, P = 0.000), urinary retention history (RR = 4. 518, P = 0. 000) and medical schedule (RR = 0. 092, P = 0. 000). Patients could be classified to high risk, median risk and low risk group, while the incidence of AUR in 3 groups is 95. 0% , 65. 3%, 0, respectively. There were significant difference between three groups (X2 =273. 04, P<0. 01). Conclusions The incidence of AUR in different BPH group is not agreea ble. Individualized treatment should be advised according to the differenl risk.