经直肠超声检查在良性前列腺增生梗阻诊断中的价值

目的　分析经直肠超声 (TRUS)测定前列腺相关指标在良性前列腺增生 (BPH)诊断中的价值。　方法　以排尿困难就诊的BPH患者 92例 ,除外影响排尿的其他因素。分别统计患者年龄、病史、国际前列腺症状评分 (IPSS)和血清PSA水平等。应用灰阶TRUS测定前列腺体积、移行带体积并计算移行带指数 (TZI) ;彩色多普勒记录尿道动脉图像 ,测定最大血流 (PK1)、最小血流 (PK2 ) ,并计算阻力指数 (RI)。测定最大尿流率 (Qmax)、最大尿流率时逼尿肌压力 (PdetQmax)并计算AG值 ,AG =PdetQmax- 2Qmax。　结果　相关性分析结果显示TZI(r =0 .80 2 ,P =0 .0 13)、IPSS(r =0 .70 4 ,P =0 .0 2 3)、RI(r=0 .897,P =0 .0 0 4 )与AG显著相关。多元回归分析结果显示TZI、RI为AG的相关因素 (复相关系数R =0 .94 7,决定系数R2 =0 .897,校正决定系数 =0 .793,P =0 .0 0 3) ,RI对AG的影响强度约为TZI的 1.94倍 (0 .770 /0 .397)。除外TZI的影响后 ,RI为AG的独立相关因素 (偏相关系数r =0 .785 ,P =0 .0 0 4 )。若定义AG≥ 4 0时为梗阻性 ,AG <4 0为非梗阻性 ;以RI≥ 0 .75为标准能诊断 93%(5 3/5 7)的梗阻患者 ,排除 91% (32 /35 )的非梗阻患者。　结论　应用多普勒TRUS测定TZI和尿道动脉的RI对BPH梗阻情况有良好的诊断价值。

Diagnostic significance of prostate related factors by transrectal Doppler ultrasonography for BPH

Objective To analyze the significance of transrectal ultrasonography (TRUS) for diagnosis of BPH. Methods The data of 92 patients with dysuria were studied,including the case age,history,IPSS and serum PSA level.The volumes of total prostate and transitional zone were measured.The PK 1 and PK 2 of uretheral artery were determined by transrectal color Doppler,Q max and P detQmax were determined by urodynamics.Transitional zone index(TZI),resistive index(RI) and AG value were calculated. Results Correlation analysis showed that TZI( r=0.802,P =0.013),IPSS( r=0.704,P =0.023),RI( r=0.897,P =0.004) were significantly related to AG(AG=P detQmax -2Qmax).Multiple regression analysis showed that TZI and RI were relative factors of AG(R=0.947, R 2=0.897, 0.793, P =0.003),and the standard partial regression coefficients were 0.397( P =0.015) and 0.770( P =0.004),respectively.RI affected AG 1.94 times as significantly as TZI(0.770/0.397).Apart from effect of TZI,RI was the independant relative factor of AG( r=0.785,P =0.004). Conclusions Measurement of RI of prostate urethral artery and TZI by transrectal Doppler ultrasonography can offer valuable help for diagnosis of BPH.