前列腺增生症患者剩余尿与膀胱出口梗阻逼尿肌收缩力的相关性研究

目的 :探讨前列腺增生症 (BPH)患者剩余尿 (RUV )与膀胱出口梗阻 (BOO)、逼尿肌收缩力相关性。方法 :对 42例 BPH患者进行尿动力学检查。结果 :RUV与 BOO呈正相关 (r =0 .716 0 ,P <0 .0 1) ,与逼尿肌等容收缩压 (Piso)呈负相关 (r =- 0 .5 718,P <0 .0 1)。术前和术后的 RU V、尿道阻力因子 (URA )的差异有显著性意义 (P<0 .0 5 ) ,而术前和术后的 Piso差异无显著性意义 (P>0 .0 5 )。结论 :BPH患者 RUV的产生及增多是由于 BOO的加重和逼尿肌功能受损的共同结果 ,在病程的不同阶段 ,BOO和逼尿肌收缩力对 RUV的产生、增多及减少具有不同的作用和意义。     

残余尿在前列腺增生所致膀胱出口梗阻中的临床意义

作应用压力－流率测定法确定前列腺增生症（ＢＰＨ）患有无膀胱出口梗阻（ＢＯＯ），并经导管法测定其残余尿，分析５１例有或无膀胱出口梗阻的前列腺增生症患的残余尿状况。ＢＯＯ组和无ＢＯＯ组分别为３１例和２０例，残余尿分别为３２．８±３５．９ｍｌ和２５．２±２２．７ｍｌ，范围分别为６～２１０ｍｌ和３～８８ｍｌ，两缚间残余尿量无显性差异（Ｐ〉０．０５）；其余指标均存在显性差异（Ｐ〈０．０１）。作认     

良性前列腺增生患者膀胱出口梗阻和逼尿肌功能的分析

目的：探讨尿动力学检查对BPH患者膀胱出口梗阻（BOO）和逼尿肌功能的诊断意义.方法：对95例BPH患者进行压力-容积和压力-流率测定.结果：95例BPH患者中BOO 57例,无BOO23例,其余15例为可疑或分析困难.BOO组前列腺体积大于无BOO组（62.4±16.1）cm^3 vs（41.0±7.1）cm^3（P＜0.05）,最大尿流率（Qmax）小于无BOO组（5.4±1.9）ml/s vs（12.4±5.0）ml/s（P＜0.05）,两组IPSS评分无差别（23.7±4.4）分vs（25.2±4.9）分（P＞0.05）.BOO组有逼尿肌不稳定收缩（DD34例,无BOO组D119例.结论：尿动力学检查有助于判断有无BOO存在,了解BPH患者的逼尿肌功能.IPSS不能判断患者的下尿路症状（LUTS）是否因BOO导致.BPH患者前列腺体积不足很大,但LUTS明显时,应行尿动力学检查.自由尿流率测定对BOO诊断有一定帮助.DI是无BOO患者发生LUTS的重要因素.     

良性前列腺增生膀胱出口梗阻的评估

目的探讨前列腺体积参数对良性前列腺增生（BPH）患者膀胱出口梗阻（BOO）及其程度的诊断价值。方法随机选择住院的BPH患者,行自由尿流率检查、压力-流率测定和经直肠前列腺B超检查,测量前列腺体积（PV）、移行带体积（TZV）,并计算移行带指数（TZI）。结果共有62例BPH患者符合入选标准。PV、TZV和TZI与Shfer梗阻级别的相关系数分别为0.277、0.315和0.200,P均〈0.05。PV、TZV和TZI与AG数的相关系数分别为0.263、0.277和0.282,p〈0.05;当400.3者的AG数明显高于PV≤0.3者（p=0.025）。结论前列腺体积参数可以预测BPH患者BOO及其程度。     

前列腺增生致膀胱出口梗阻后逼尿肌功能改变对尿动力学参数的影响

目的探讨良性前列腺增生症（BPH）致膀胱出口梗阻（BOO）后逼尿肌功能改变对尿动力学参数的影响。方法109例具有完整尿动力学结果的BPH患者根据有无B00分为梗阻组和非梗阻组;梗阻组根据梗阻级别分Ⅲ、Ⅳ、Ⅴ、Ⅵ级4组;逼尿肌收缩力分为逼尿肌收缩力减弱（DCA）与收缩力正常组;逼尿肌不稳定（DI）分DI与非DI;膀胱顺应性（BC）分高、正常、低顺应性三组;28例患者行经尿道前列腺切除术（TURP）术前及术后尿动力参数对比。结果BOO组的前列腺体积（PV）、国际前列腺症状评分（IPSS）、DI、急性尿潴留（AUR）发生率明显高于非BOO组（P〈O．05）;BOO组的最大尿流率（Qmax）、BC值、DCA发生率明显低于非BOO组（P〈0．05）;逼尿肌收缩力正常组的残余尿（RV）与BC值明显低于减弱组（P〈0．05）,而BOO和DI的发生率明显高于减弱组（P〈0．01）;DI组的年龄、BC值及DCA的发生率明显低于非DI组（P〈0．05）,而B00级别和AUR的发生率明显高于非DI组（P〈0．01）;低BC组IPSS、BOO级别、AUR发生率明显高于正常及高BC组（P〈0．05）,而DCA发生率明显低于正常及高BC组（P〈0．01）;术后Qmax、BC值较术前明显升高（P〈0．05）,RV、IPSS、DI发生率较术前明显减小（P〈0．01）。结论①BOO常与低顺应性膀胱、DI、AUR合并存在;②IPSS评分不能提示是否存在DI,DI的存在不影响IPSS评分;③TURP是治疗前列腺增生的金标准;④尿动力检查能全面了解有无BOO及BOO所致逼尿肌功能改变情况,对BPH的临床鉴别诊断、预后估计及选择恰当治疗方案都具有重要意义。     

前列腺增生患者膀胱出口梗阻程度对尿动力学指标的影响

目的探讨前列腺增生患者膀胱出口梗阻程度对尿动力学指标的影响及临床意义。方法分析113例前列腺增生患者的尿动力学资料,根据膀胱出口有无梗阻分为梗阻组和非梗阻组,梗阻组又根据梗阻级别分Ⅲ、Ⅳ、Ⅴ、Ⅵ级四组。结果梗阻组的最大尿流率、膀胱顺应性值和逼尿肌收缩力减弱发生率明显低于非梗阻组,逼尿肌不稳定和急性尿潴留发生率明显高于非梗阻组。梗阻组内各梗阻级别之间在顺应性值、逼尿肌不稳定和急性尿潴留的发生率上无显著性差异,随梗阻级别增加尿流率和逼尿肌收缩功能受损发生率下降。结论一些反映排尿异常和逼尿肌功能的尿动力学指标受膀胱出口梗阻程度影响,在无法进行压力/流率分析时综合分析这些指标有助于判断出口梗阻及其程度。     

良性前列腺增生膀胱出口梗阻评判指标分析

目的 :探讨良性前列腺增生 (BPH)患者评判膀胱出口梗阻 (BOO)程度临床指标的应用价值。　方法 :35 8例BPH患者 ,根据膀胱镜下前列腺尿道梗阻的程度分为 3级 :1级为轻度梗阻 ;2级为中度梗阻 ;3级为重度梗阻 ;并根据Sch fer图定量划分梗阻程度 :0～Ⅵ级。结合相应的前列腺体积、最大尿流率、残余尿、国际前列腺症状评分(IPSS)以及膀胱的稳定性等项指标 ,进行单因素方差分析和相关分析 ,并计算相关指数。　结果 :按膀胱镜观测到的前列腺挤压尿道的程度将患者划分为 3级 :其中 1级 2 7例 ,2级 2 36例 ,3级 95例。前列腺体积为 16～ 14 5(4 7.0 4± 15 .6 1)ml。前列腺体积与前列腺挤压尿道的程度成正相关 (r =0 .2 9,R2 =0 .0 8) ,随着患者前列腺体积增大 ,前列腺挤压尿道的程度加重 (F =4 .2 16 ,P <0 .0 5 )。前列腺挤压尿道的程度与IPSS成正相关 (r =0 .35 ,R2 =0 .12 ) ,I PSS伴随着前列腺挤压尿道程度的增高而增高 (F =8.4 0 8,P <0 .0 0 1) ;生活质量评分随着前列腺挤压尿道程度的加重而增高 (F =10 .2 0 4 ,P <0 .0 0 1) ,两者成正相关 (r =0 .17,R2 =0 .0 3)。整个研究人群的平均最大尿流率为 (10 .0 2± 2 .12 )ml/min ,残余尿量为 (84 .0 6± 36 .5 0 )ml。最大自由率随着前列腺挤压尿道程度的加?     

一氧化氮与前列腺增生膀胱颈梗阻关系的研究

目的：探讨一氧化氮（ＮＯ）与前列腺增生（ＢＰＨ）膀胱颈梗阻（ＢＰＯ）发病的关系。方法：应用双波长分光光度法,组织化学法检测２０例存在ＢＰＯ及１０例正常前列腺组织中的ＮＯ合酶（ＮＯＳ）活性及ＮＯＳ神经。结果：ＢＰＨ组织中的ＮＯＳ活性,ＮＯＳ神经的长度密度均较正常前列腺组织明显降低;ＮＯＳ活性,ＮＯＳ神经的Ｌｖ与ＢＰＨ患者的症状评分及反映ＢＰＯ客观指标的尿动力学参数相关。     

尿道压力测定在评价良性前列腺增生患者膀胱出口梗阻中作用的研究

目的探讨尿道压力测定在评价良性前列腺增生（BPH）患者膀胱出口梗阻中的作用。方法回顾性分析1999年9月至2005年7月因尿频、尿急、排尿困难等下尿路症状就诊的1281例BPH患者的尿动力学检查结果,患者平均年龄67岁。按照国际尿控协会标准,分为无梗阻组168例,可疑梗阻组287例和梗阻组826例。结果梗阻组与无梗阻组患者的平均年龄分别为70岁和57岁,膀胱容量分别为（259±67）和（353±27）ml,剩余尿分别为25．5（0～200）和0．7（0～15）ml,排尿量分别为（157±88）和（288±36）ml,排尿时间分别为（55±23）和（43±7）s。前列腺平台面积分别为（2052±446）和（1055±137）mm×cm H2O,前列腺长分别为（5．0±1．0）和（3．5±0．4）cm,功能曲线长度分别为（6．3±1．1）和（4．8±0．4）cm,膀胱颈压分别为（33．1±12．2）和（15．0±3．6）cm H2O,精阜压分别为（30．7±10．5）和（17．0±3．8）cm H2O,组间比较差异均有统计学意义（P〈0．01）。以压力流率测定结果为标准,受试者工作特征曲线显示,前列腺平台面积≥1440 mm×cm H2O作为判断梗阻标准,敏感性为95．2％,特异性为99．6％。结论前列腺平台面积可以作为判断BPH患者膀胱出口梗阻的有效指标。     

良性前列腺增生患者膀胱出口梗阻及逼尿肌收缩强度对剩余尿的影响

目的　探讨良性前列腺增生 (BPH)患者膀胱出口梗阻 (BOO)及逼尿肌收缩强度与剩余尿的关系。　方法　应用尿动力学方法检测 181例BPH患者BOO情况和逼尿肌收缩强度 ,以导管法结合膀胱灌注量与排出量之差确定剩余尿 ,对相互关系进行统计学分析。　结果　 181例患者剩余尿量 0～ 2 0 0ml。逼尿肌收缩强度减弱 ,剩余尿量增多 (F =12 .14 3,P =0 .0 0 1) ;BOO加重 ,剩余尿量无明显改变 (F =2 .386 ,P =0 .0 71)。 2 5例 (13.8% )患者逼尿肌收缩强度减弱或正常时仍有较多剩余尿(>10 0ml)。　结论　剩余尿增多主要由逼尿肌收缩强度减弱所致 ,而随着BOO加重 ,剩余尿量无明显变化     

Diagnosis of female bladder outlet obstruction and relevance of the parameter area under the curve of detrusor pressure during voiding: preliminary results

PURPOSE: The diagnosis of bladder outlet obstruction in women by pressure flow study may be difficult because there are several definitions of bladder outlet obstruction, several parameters and no standard cutoffs. We evaluated the ability of pressure flow studies to separate women into unobstructed, equivocal and obstructed groups. MATERIALS AND METHODS: In a prospective study 85 women with lower urinary tract symptoms underwent clinical evaluation, including physical examination, voiding cystourethrography, endoscopy, flow rate and post-void residual volume measurement. A pressure flow study was performed 15 days later. The pressure flow study parameters were maximum flow, post-void residual volume, detrusor pressure at maximum flow, vesical pressure at maximum flow, area under the curve of detrusor pressure during voiding and area under the curve of detrusor pressure during voiding adjusted for voided volume. After considering the clinical evaluation 2 urologists classified the patients into 3 groups, namely unobstructed, equivocal and obstructed, as the traditional classification. Linear discriminant analysis was then performed using the traditional classification and pressure flow study data. RESULTS: Mean patient age was 55 years (range 18 to 83). According to the traditional classification there were 36 unobstructed, 28 equivocal and 21 obstructed cases. Significant differences were noted in all pressure flow study parameters (analysis of variance p <0.05). Linear discriminant analysis showed that area under the curve of detrusor pressure during voiding adjusted for voided volume was the most statistically discriminating parameter. Of the cases 86%, 36% and 57% were identically categorized by the traditional and area under the curve of detrusor pressure during voiding adjusted for voided volume parameter classifications in the unobstructed, equivocal and obstructed groups, respectively. The other pressure flow study parameters showed less satisfactory results. CONCLUSIONS: Area under the curve of detrusor pressure during voiding adjusted for voided volume appears to be the most discriminating urodynamic parameter of female bladder outlet obstruction. Other studies are needed to test the reliability and validity of this new parameter.     

经超声逼尿肌厚度测定在无创诊断女性膀胱出口梗阻中的应用

目的 探讨经超声逼尿肌厚度测定在女性膀胱出口梗阻诊断中的应用价值.方法 93例伴有LUTS的女性患者,行压力流率测定过程中,当膀胱容量为250 ml或最大膀胱容量的50％时,应用7.5 MHz高频线纵超声探头测定膀胱前壁逼尿肌厚度.以Qmax≤12 ml/s以及最大尿流率时逼尿肌压力≥25 cm H2O(1 cm H2O =0.098 kPa)作为诊断女性膀胱出口梗阻的标准,将患者分为梗阻及非梗阻两组,比较两组年龄、尿动力学参数及逼尿肌厚度的差异.应用相对工作特征曲线评价逼尿肌厚度测定作为诊断工具的价值. 结果 梗阻组42例,非梗阻组51例.两组年龄分别为(61.2±8.3)、(59.9±7.7)岁(P=0.44),最大膀胱灌注容量分别为(292.2±82.3)、(308.1±87.5)ml(P =0.37),组间比较差异均无统计学意义;两组最大逼尿肌压力[(43.1±11.2)、(16.2±7.1)cm H2O,P=0.00]、最大尿流率时逼尿肌压力[(34.3±8.2)、(13.1±7.8)cm H2O,P=0.00]、Qmax[(7.4±3.2)、(17.4±4.1)ml/s,P=0.00]、排尿量[(157.1±63.7)、(251.2±77.4)ml,P=0.00]、残余尿量[(117.5±71.3)、(37.7±18.1)ml,P=0.00]及逼尿肌厚度[(1.8±0.3)、(1.4±0.2)mm,P =0.00]比较差异均有统计学意义.当临界值≥1.9 mm时,特异性和阳性预测值均为100％,敏感性为38％,阴性预测值为62％.其曲线下面积为0.88±0.06. 结论 经超声逼尿肌厚度测定诊断女性膀胱出口梗阻具有无创、方便、可靠的特点.当临界值≥1.9 mm时,具有较高的特异度和阳性预测值,在一定程度上可取代压力流率测定.     

The relationship of detrusor instability and symptoms with objective parameters used for diagnosing bladder outlet obstruction: a prospective study

PURPOSE: Detrusor instability is a common urodynamic finding in patients with prostatic obstruction. In prospective fashion we evaluated detrusor instability in patients with lower urinary tract symptoms attributable to benign prostatic hyperplasia and determined its possible association with the degree of obstruction. MATERIALS AND METHODS: A total of 459 men with a mean age plus or minus standard deviation of 60.4 +/- 9.4 years who were investigated for lower urinary tract symptoms at our facility answered an Arabic standardized version of International Prostate Symptom Score and underwent simple uroflowmetry, outpatient cystoscopy and transrectal ultrasound. Invasive urodynamics, including filling and voiding cystometry, was done with pressure flow analysis according to the Sch?fer nomogram. Statistical significance was tested by the Mann-Whitney U and Wilcoxon rank sum tests. RESULTS: Of the 459 patients 108 (23.5%) had detrusor instability. Instability significantly affected patient symptom score and conception of quality of life. Moreover, instability significantly affected the degree of obstruction, as measured by the maximum flow rate, post-void residual urine, prostate volume and Sch?fer grade of obstruction. CONCLUSIONS: Detrusor instability affects patient symptoms and quality of life. It also signifies a more severe degree of obstruction in male patients with lower urinary tract symptoms and bladder outlet obstruction due to benign prostatic hyperplasia.     

残余尿在前列腺增生症所致膀胱出口梗阻中的临床意义

作者应用压力－流率测定法确定前列腺增生症（ＢＰＨ）患者有无膀胱出口梗阻（ＢＯＯ），并经导管法测定其残余尿，分析５１例有或无膀胱出口梗阻的前列腺增生症患者的残余尿状况。ＢＯＯ组和无ＢＯＯ组分别为３１例和２０例；残余尿分别为３２．８±３５．９ｍｌ和２５．２±２２．７ｍｌ，范围分别为６～２１０ｍｌ和３～８８ｍｌ。两组间残余尿量无显著性差异（Ｐ＞０．０５）；其余指标均存在显著性差异（Ｐ＜０．０１）。作者认为以残余尿作为选择ＢＰＨ患者手术的重要指标并不可靠，ＢＯＯ不是产生残余尿的唯一原因。ＢＯＯ患者可无明显残余尿，无明显残余尿的ＢＰＨ患者不能除外ＢＯＯ。     

Relative bladder outlet obstruction

PURPOSE: Currently bladder outlet obstruction in males is defined by the provisional International Continence Society nomogram which is partly based on expert opinion and partly on measurements before and after transurethral prostate resection. Recently there has been some interest in the development of a similar nomogram for females. MATERIALS AND METHODS: We studied the possibility of defining bladder outlet obstruction based on a sign that it causes, namely post-void residual urine. RESULTS: The probability of relative post-void residual urine exceeding 20% of bladder capacity was modeled in males and females using 1 parameter, that is URA/w20 or the ratio of the obstruction parameter urethral resistance factor (URA)-to-the bladder contractility parameter Watts factor at 20% (w20). URA/w20 represents relative bladder outlet resistance or bladder outlet resistance normalized to bladder contractility. Above a threshold of URA/w20 = 6.8 in females and 8.2 in males a relative post-void residual exceeding 20% was noted in 90% of measurements. These thresholds may be used to define relative obstruction. The provisional International Continence Society nomogram for obstruction in males was transformed into an identical nomogram for females by equating the probabilities of post-void residual urine in each gender. The latter differed from that in men, in that the lines demarcating the zones were horizontal or flow rate independent but the intercepts were approximately the same at 20 and 40 cm. water. CONCLUSIONS: Instead of defining obstruction as an absolute level of bladder outlet resistance we suggest that it is better to define it relatively, that is as a level of bladder outlet resistance that depends on bladder contractility.     

多沙唑嗪对兔膀胱出口部分梗阻致膀胱顺应性减低的影响

目的 探讨多沙唑嗪对兔膀胱出口部分梗阻后膀胱顺应性改变的影响.方法 成年雄性新西兰兔40只随机分为4组,每组10只,A组为假手术对照组,B组为膀胱出口部分梗阻组,C组为膀胱出口部分梗阻后口服多沙唑嗪组,D组为假手术后给予多沙唑嗪组.各组于14周行尿动力学检测,检测完成后处死并留取膀胱标本,行膀胱称重.结果 4组膀胱标本质量分别为(3.2±0.9)、(14.1±2.3)、(5.0±2.0)、(2.9±0.5)g;B、C组均高于A、D组,B组高于C组,差异均有统计学意义(P＜0.01);A、D组间比较差异无统计学意义(P＞0.05).4组逼尿肌漏尿点压分别为(10.2±2.5)、(18.8±6.1)、(13.5±4.7)、(11.6±3.6)cm H2O(1 cm H2O=0.098 kPa),B组高于A、D组,差异有统计学意义(P＜0.01),且高于C组,差异有统计学意义(P＜0.05);A、C、D组间差异无统计学意义(P＞0.05).膀胱顺应性分别为(2.86±0.56)、(1.22±0.39)、(4.25±2.19)、(2.90±0.53)ml/cm H2O,B组与A、D组相比明显下降,差异有统计学意义(P＜0.01);C组高于A、D组,差异有统计学意义(P＜0.05);A、D组间差异无统计学意义(P＞0.05).结论膀胱出口部分梗阻后早期应用多沙唑嗪治疗能够延迟梗阻对膀胱顺应性的损害,保护膀胱储尿功能.

Abstract：

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.     

膀胱出口梗阻指数在评估良性前列腺增生症膀胱出口梗阻中的应用

目的 探讨膀胱出口梗阻指数(BOON)在评估前列腺增生患者膀胱出口梗阻(BOO)中的意义.方法 对临床有下尿路症状,怀疑存在因前列腺增生症(BPH)导致膀胱出口梗阻的76例患者,测定前列腺体积(经直肠),最大自由尿流率(Qmax)和平均排尿量,通过公式计算BOON=前列腺体积(cm3)-3×Qmax(ml/s)-0.2×平均排尿量(ml).同时对患者进行压力.流率测定,计算AG值和Schafer梗阻级别,与BOON对照,分析利用BOON评估膀胱出口梗阻的准确性.结果 将本组患者年龄、前列腺体积、最大尿流率、残余尿量及BOON值,以AG作为因变量,同AG进行多元线性回归分析.整体回归方程中R=0.542(P=0.000),其中BOON值同AG值相关性最强(P=0.000).18例BOON值>-10,此时利用BOON判断BOO的敏感性为31%,特异性为100%,取BOON>-20时,敏感性为42.4%,特异性为88.2%;取BOON>-30时,敏感性为66.1%,特异性为82.4%;而取BOON>-40时,敏感性为77.9%,其特异性为64.7%.取BOON值-30作为分界点,在不明显降低特异性的同时,能够更敏感的判断BOO,BOON数值越大,利用BOON判断膀胱出口梗阻的特异性越高.结论 通过测定前列腺体积,最大自由尿流率(Qmax)和平均排尿量计算膀胱出口梗阻指数,取BOON>-30为分界点,是预测前列腺增生症是否存在膀胱出口梗阻的一种简易、无创方法,具有较好的特异性和敏感性.     

BPH梗阻致膀胱功能改变的尿动力学研究

为探讨前列腺增生症（ＢＰＨ）梗阻致膀胱功能改变的临床意义，对５９例ＢＰＨ病人进行全面尿动力学检查。结果：（１）最大逼尿肌等容收缩压（Ｐｉｓｏ）与逼尿肌收缩速度呈正相关（ｒ＝０．７１６７，Ｐ＜０００１）。（２）Ｐｉｓｏ随膀胱充盈量增加而显著下降（Ｐ＜０００１）。（３）Ｐｉｓｏ与ＢＰＨ梗阻程度呈正相关性（ｒ＝０．６７８１，Ｐ＜０００１）。（４）当剩余尿量≥１００ｍｌ，逼尿肌储能显著下降（Ｐ＜０００１）。（５）不稳定膀胱组的Ｐｉｓｏ显著高于稳定膀胱组。结果认为：不稳定膀胱是引起ＢＰＨ病人临床症状的主要因素之一，膀胱等容收缩试验应用于ＢＰＨ病人有重要的临床价值     

良性前列腺增生患者并发膀胱过度活动症与膀胱出口梗阻的关系

目的：研究分析BPH患者并发膀胱过度活动症（OAB）与膀胱出口梗阻（BOO）程度的相关性。方法：163例BPH患者,根据OAB症状评分（OABSS）将患者进行严重程度分级：0级无尿急等OAB症状;OABSS为1级≤5分;2级6-11分;3级≥12分。经腹超声测定前列腺三径和前列腺突入膀胱的距离（IPP）,尿动力学检查测定最大尿流率（Q_max）、剩余尿,最大尿流率时的逼尿肌压力（P＆_det@Q_max）,并计算出AG值,进行方差分析和相关性分析检验。结果：按OAB症状严重程度分为四组：0级44例,1级35例,2级46例,3级38例。OAB症状程度轻重与患者年龄、前列腺体积、最大自由尿流率等无相关。IPSS评分随OAB症状加重而增高,0～3级分别为（8．4±4．2）、（12．7±3．8）、（15．6±3．6）、（18．5±4．1）分（F=49．931,P=0．000）;前列腺中叶增生程度（IPP）呈现显著性升高趋势,0～3级分别为（0．4±0．3）、（0．8±0．5）、（1．1±0．7）、（1．3±0．6）cm（F=21．385,P=0．000）;剩余尿量显著增多,0-3级分别为（50．6±36．1）、（64．5±29．0）、（68．3±30．8）、（72．71±39．2）ml（F=3．345,P=0．021）;P_det@Q_max显著增高,0～3级分别为（48．3±7．5）、（53．6±27．9）、（58．7±29．1）、（70．4±26．8）cmH2O（1cmH2O=0．098kPa,F=3．722,P=0．012）。BOO（AG〉40）发生率分别为：0级36．4％（16／44）、1级54．3％（19／35）、2级58．7％（27／46）、3级73．7％（28／38）,显示OAB症状与AG值呈正相关（r=0．263,P=0．001）。结论：BPH患者并发膀胱过度活动症与膀胱出口梗阻存在显著相关性。