良性前列腺增生患者前列腺体积参数与膀胱出口梗阻的相关性研究

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（B00）及其程度的诊断价值。方法对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，测量最大尿流率、Shaefer梗阻级别、AG数、前列腺体积（PV）、移行带体积（TZV）和移行带指数（TZI）。结果共有62例BPH患者入选。PV、TZV、TZI与Qmax的相关系数分别为-0．105、-0．173和-0．258。P值均〉0．05。PV、TZV和TZI与Sharer梗阻级别的相关系数分别为0．277、0．315和0．200。P值均〈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值均〈0．05；当40〈PV≤60ml时。PV与AG数呈正相关（r=0．263，P〈0．05）；TZI：0．3是BOO的一个分界点。TZI〉0．3者的AG数明显大于PV≤0．3者（P〈0．05）。结论前列腺体积参数可以预测BPH患者B00及其程度。     

前列腺移行区体积和移行区指数在诊断良性前列腺增生中的作用

目的 :评价前列腺移行区体积 (TZV)和移行区指数 (TZI)在诊断良性前列腺增生 (BPH)中的作用。方法 :采用经直肠超声测量 2 62例患者的前列腺体积 (TPV)和TZV ,其中A组 2 2 0例为有症状 ,未出现过尿潴留的BPH患者 ,B组 19例为反复出现尿潴留的BPH患者 ,对照组 2 3例为非BPH患者 ,并推算TZI(TZI =TZV/TPV)。以上患者同时接受了国际前列腺症状评分 (IPSS)、生活质量评分 (QOL)、最大尿流率 (Qmax)检查。所得数据进行统计学处理。结果 :A组、B组和对照组之间的TPV、TZV、TZI、IPSS、QOL、Qmax比较差异均有显著性意义 ,年龄与TPV和TZV有非常显著相关性 (分别r =0 .2 4,P <0 .0 1;r =0 .2 5 ,P <0 .0 1) ,与Qmax有非常显著负相关性 (r =- 0 .2 7,P <0 .0 1) ,与IPSS有显著相关性 (r =0 .15 ,P <0 .0 5 ) ,与QOL无相关性 (r =0 .11,P >0 .0 5 )。TPV与IPSS、QOL、Qmax有显著相关性 (r =0 .2 6,r =0 .2 0 ,r =- 0 .2 9,P均 <0 .0 5 ) ,而TZV和TZI与IPSS ,QOL ,Qmax均有非常显著相关性 (分别r =0 .40 ,r =0 .3 2 ,r =- 0 .43 ,P均 <0 .0 1;r =0 .5 1,r =0 .41,r =- 0 .5 2 ,均P <0 .0 1)。结论 :BPH患者随着年龄的增加 ,TPV、TZV、IPSS、QOL增加 ,Qmax减小。发生尿潴留的BPH患者 ,其TPV、TZV和TZI大于没有出现过     

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。     

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。     

前列腺假定圆面积比在评价膀胱出口梗阻中的意义

目的　分析经直肠超声 (TRUS)测定良性前列腺增生相关指标对诊断膀胱出口梗阻的意义。　方法　良性前列腺增生患者 78例。年龄 6 2～ 78岁 ,平均 (71.6± 5 .0 )岁。IPSS 18～ 2 8,平均 2 2 .0± 2 .2。应用TRUS测定前列腺体积的相关指标 ,同时行尿动力学检查并计算AG值。将年龄、前列腺体积、移行带体积、移行带指数 (TZI)、假定圆面积比 (PCAR)、IPSS等参数分别与AG值进行相关性分析。　结果　前列腺体积 (70 .0 2± 6 2 .10 )ml、移行带体积 (36 .33± 39.37)ml、TZI 0 .4 8±0 .15、PCAR 0 .72± 0 .10。最大尿流率 (Qmax) (8.2 5± 4 .2 1)ml/s、最大尿流率时逼尿肌压力(Pdet.Qmax) (83.2 8± 32 .5 6 )cmH2 O(1cmH2 O =0 .0 98kPa)。相关分析提示 ,TZI(r =0 .75 7,P =0 .0 15 )、IPSS(r =0 .6 93,P =0 .0 2 8)、PCAR(r =0 .80 6 ,P =0 .0 0 8)与AG值显著相关。多元回归分析结果显示 :TZI、PCAR为AG的相关因素 (复相关系数r =0 .95 2 ,决定系数r =0 .90 6 ,校正决定系数r =0 .86 9,P =0 .0 0 3) ,两者的标准化偏回归系数分别为 0 .4 4 0 (P =0 .0 18)和 0 .717(P =0 .0 14 ) ,PCAR对AG的影响强度约为TZI的 1.6 3倍。除外TZI的影响后 ,PCAR为ΔAG的独立相关因素(偏相关系数r =0 .883,P =0 .0 0 8)。     

良性前列腺增生患者前列腺体积和移行区体积随年龄变化的调查

目的:调查良性前列腺增生(BPH)患者各年龄段前列腺总体积(TPV)、前列腺移行区体积(TZV),计算TZV与TPV的比值即移行区指数(TZI)的数值。分析年龄与上述指标的相关性。方法:经直肠B超测量1 563例BPH患者前列腺和前列腺移行区最大左右径、前后径和上下径,根据公式分别计算出TPV、TZV以及TZI。分析年龄与前列腺体积各参数的相关性。结果:BPH患者各年龄组TPV、TZV和TZI值分别为:50~59岁年龄组TPV(32.27±15.76)ml、TZV(9.55±7.98)ml、TZI 0.28±0.13;60~69岁年龄组TPV(40.93±17.45)ml、TZV(14.94±11.83)ml、TZI 0.34±0.16;70~79岁年龄组TPV(46.56±20.31)ml、TZV(19.54±19.25)ml、TZI 0.39±0.16;80~89岁年龄组TPV(47.85±26.63)ml、TZV(20.40±16.78)ml、TZI 0.41±0.19。BPH患者的TPV、TZV与年龄成显著正相关性(r1=0.232,r2=0.256,P均<0.01),TZV与年龄的相关系数要高于TPV与年龄的相关系数。结论:BPH患者的TPV、TZV值随着年龄的增长而增加,但是TZV增长的幅度要高于TPV增长的幅度,前列腺增生以移行区增生最为显著,并且我国BPH患者的移行区指数与其他人种之间可能存在不同。     

BPH患者组织学前列腺炎与PSA、前列腺体积、PSAD、IPSS、Qmax及PVR的相关性研究

目的:探讨BPH患者组织学前列腺炎与PSA、前列腺体积、PSA密度(PSAD)、IPSS、最大尿流率(Qmax)及残余尿量(PVR)的相关性。方法:手术切除或经尿道前列腺电切术(TURP)治疗的BPH患者673例。按照是否伴有组织学前列腺炎将患者分为两组:A组:BPH伴组织学前列腺炎;B组:BPH不伴有组织学前列腺炎。比较两组患者PSA、前列腺体积、PSAD、IPSS、Qmax及PVR。结果:A组PSA水平为(5.64±2.48)μg/L,前列腺体积(43.66±13.11)ml,PSAD 0.129±0.048,IPSS(24.72±5.39)分,Qmax(6.94±3.23)ml/s,PVR(124.90±49.80)ml;B组PSA水平为(4.97±1.99)μg/L,前列腺体积(40.41±11.44)ml,PSAD 0.123±0.034,IPSS(23.40±6.21)分,Qmax(7.75±3.52)ml/s,PVR(112.73±50.03)ml。A组PSA水平、前列腺体积、IPSS和PVR均明显高于B组(P<0.05);A组Qmax明显低于B组(P<0.05);PSAD两组间差异无统计学意义(P>0.05)。结论:组织学前列腺炎能明显增加患者的PSA水平、前列腺体积、IPSS和PVR,降低患者Qmax。但是组织学前列腺炎与PSAD无关;组织学前列腺炎是影响BPH临床进展的重要因素。     

经直肠B超测量前列腺体积与TURP手术的相关性研究

目的 :探讨良性前列腺增生 (BPH)患者前列腺总体积 (PV)及移行区体积 (TZV)与TURP手术时间、术中失血量、切除前列腺组织重量间的相互关系。方法 :采用经直肠超声 (TRUS)测定 88例BPH患者PV及TZV ,并分别与手术指标及切除标本进行相关回归分析。结果 :TZV与手术时间 ( r=0 .874,P <0 .0 1)、术中失血量 (r =0 .915 ,P <0 .0 1)、切除组织重量 (r =0 .966,P <0 .0 1,误差 =9.9% )均显著相关 ,PV与切除组织重量也有显著相关 ,但误差达 5 5 .9%。TZV≥ 3 0ml者较TZV <3 0ml者手术时间明显延长、术中失血量增加、TURS先兆发生率增高 (P <0 .0 1)。结论 :TRUS可准确估计PV及TZV ;术前测定TZV对BPH的诊治有重要参考价值     

比较不同剂量舍尼通在防止良性前列腺增生疾病进程中的作用

目的:比较服用不同剂量舍尼通在防止BPH疾病进程的疗效和安全性。方法:将国际前列腺症状评分(IPSS)>7的用舍尼通治疗的BPH患者240例分成两组。试验组120例为口服舍尼通750mg/次,2次/d;对照组120例为口服舍尼通375mg/次,2次/d,疗程均为4年。观察2组治疗前后IPSS、前列腺体积、剩余尿、最大尿流率(Qmax)、血清前列腺特异性抗原(PSA)的变化,以及尿潴留和接受外科治疗的发生率。结果:试验组治疗前IP-SS为(20.1±4.1)分,前列腺体积为(37.8±12.5)ml,剩余尿为(42.5±6.6)ml,Qmax为(10.0±3.5)ml/s。试验组治疗4年后IPSS为(10.5±5.6)分,前列腺体积为(29.2±9.5)ml,剩余尿为(15.2±3.1)ml,Qmax为(16.2±4.5)ml/s。对照组治疗前IPSS为(19.2±3.8)分,前列腺体积为(37.1±11.9)ml,剩余尿为(41.8±6.1)ml,Qmax为(10.2±3.8)ml/s。对照组用药4年后IPSS为(14.9±4.3)分,前列腺体积为(34.7±9.8)ml,剩余尿为(25.6±4.6)ml,Qmax为(13.5±4.1)ml/s。试验组比对照组IPSS、前列腺体积、剩余尿、Qmax改善更明显(P<0.0001)。与治疗前比,IPSS试验组在治疗3个月后[(16.7±3.9)分,P<0.0001],对照组在6个月后[(17.6±3.3)分,P=0.0010)有改善。前列腺体积试验组在治疗1年后[(15.6±3.2)ml,P=0.0487]有改善,对照组4年时[(25.6±4.6)ml,P=0.1040]仍无改善。剩余尿试验组[(38.7±6.1)ml,P<0.0001]与对照组[(40.2±5.5)ml,P=0.0422]在治疗3个月后都有改善。Qmax试验组在治疗6个月后[(13.2±4.1)ml/s,P<0.0001],对照组在9个月后[(12.0±3.7)ml/s,P=0.0005]有改善。尿潴留发生数试验组(5人次)比对照组(16人次)低(P=0.0147)。接受外科治疗的发生数更低试验组(2人次)比对照组(8人次)低(P=0.0462)。试验组PSA治疗前为(4.5±3.3)ng/ml,治疗后为(4.1±2.9)ng/ml,二者无明显变化(P=0.3496)。对照组PSA治疗前为(4.6±2.9)ng/ml,治疗后为(4.3±2.1)ng/ml,二者无明显变化(P=0.3805)。试验组和对照组均无发生舍尼通引起药物不良反应。结论:长期采用舍尼通750mg/次剂量治疗比375mg/次剂量改善BPH所导致的症状更快、更显著,在防止良性前列腺增生疾病进展上也更好,且无明显不良反应。     

膀胱出口梗阻指数在良性前列腺增生诊断中的临床价值

目的:评估膀胱出口梗阻指数(BOOI)在BPH诊断中的临床应用价值。方法:回顾性收集分析2016年7月至2018年9月收治并诊断为BPH的199例患者的尿动力学检查结果并计算BOOI,根据BOOI结果分为BOO组、可疑BOO组以及无BOO组,比较3组患者前列腺体积(PV)、国际前列腺症状评分(IPSS)、排尿期IPSS(IPSS-VS)、生活质量(QOL)评分、最大尿流率(Qmax)以及残余尿量(PVR)。使用Pearson直线相关性分析判断BOOI与PV、IPSS、IPSS-VS、QOL、Qmax、PVR之间的相关性。结果:3组之间年龄(P=0.195)、PSA(P=0.380)、IPSS(P=0.380)、IPSS-VS(P=0.380)、QOL(P=0.380)、Qmax(P=0.380)、PVR(P=0.912)均无统计学差异,但BOO组PV[(58.8±30.0)ml]明显大于可疑BOO组[(49.8±33.9)ml]和无BOO组[(45.5±26.0)ml](P=0.031)。Pearson直线相关性分析发现BOOI与IPSS(r=-0.020,P=0.778)、IPSS-VS(r=-0.013,P=0.853)、QOL(r=-0.107,P=0.132)、Qmax(r=-0.130,P=0.066)、PVR(r=-0.056,P=0.433)均无显著相关性,而对于PV,尽管P=0.012,但|r|=0.178<0.4,因此认为BOOI与PV亦无明显相关性。结论:BOOI与PV、IPSS、IPSS-VS、QOL、Qmax以及PVR均无显著相关,单以BOOI结果诊断BOO并不可靠,BOO的诊断需要同时结合临床实际才能做出。     

Is the higher prevalence of benign prostatic hyperplasia related to lower urinary tract symptoms in Korean men due to a high transition zone index?

OBJECTIVE: Asian men generally have smaller prostate gland sizes than their Western counterparts. Nonetheless, the prevalence of lower urinary tract symptoms (LUTS) is similar between native Asian men and men in the Western hemisphere. The purpose of this study was to determine if the enlargement of the transition zone volume (TZV) relative to the overall prostate volume (PV) might account for the prevalence of LUTS among Korean men despite having "smaller" prostates. METHODS: Three hundred and seventy consecutive age-matched men (94 Caucasian, 94 Hispanic, 93 African-American, and 89 Korean) with LUTS were evaluated utilizing the International Prostate Symptom Score (IPSS), peak flow rate (Q(max)), serum PSA and transrectal ultrasound (TRUS). The ratio of TZV to total PV was used to determine the transition zone index (TZI). RESULTS: Mean baseline IPSS and Q(max) were significantly different (p<0.001 and p<0.03) for Korean men (19.9+/-7.6 and 11.3+/-4.2) in comparison to African-American (14.6+/-3.7, 12.6+/-4.1), Caucasian (13.4+/-4.3, 12.5+/-3.8), and Hispanic (13.9+/-3.1, 11.9+/-4.5) men. Regardless of race, TZI correlated with IPSS (r=0.31, p<0.01) and Q(max) (r=0.26, p<0.04). Mean TZI was significantly (p<0.001) higher in Korean and African-American men (0.45+/-0.08 and 0.44+/-0.05, respectively) than Caucasian and Hispanic men (0.39+/-0.03 and 0.38+/-0.02, respectively). CONCLUSIONS: Among age-matched, ethnically diverse men with moderate to severe LUTS, Korean men demonstrated more clinical symptoms and a higher ratio of transition zone enlargement relative to total prostate in comparison to Caucasian, Hispanic, and African-American men. The clinical significance of these findings remains to be determined.     

膀胱重量与前列腺增生临床参数的相关性研究

目的探讨膀胱重量（Bw）与常用BPH临床参数的相关性。方法81例BPH患者分为尿潴留与非尿潴留组,经腹B超（TAUS）测量其BW,将BW与年龄、国际前列腺症状评分（I—PSS）、生活质量评分（QOL）、前列腺体积（PV）、排尿后残余尿（PVR）、最大尿流率（Qmax）和前列腺特异抗原（PSA）进行相关分析。结果81例患者年龄平均（71．73&#177;5．80）岁,IPSS（15．89&#177;3．44）分,QOL（3．88&#177;0．93）分,PV（61．55&#177;19．67）m1．PVR（71．11&#177;30．83）ml,Qmax（9．93&#177;2．74）ml／s,PSA（3．30&#177;2．63）rig／ml,BW（75．85&#177;18．45）g;两组间年龄、QOL、PV、PRV、Qmax、PSA和BW存在显著性差异,而I—PSS差异无显著性;BW与年龄、IPSS、QOL、PV、PRV、PSA呈显著正相关,相关系数分别为（r=0．587,r=0．481,r=0．816,r=0．911,r=0．784,r=0．864,P〈0．001）,而与Qmax呈显著负相关（r=-0．769,p〈0．001）。结论BW能反映BPH的严重程度,对指导判断BPH严重程度和外科干预时机可能有重要的临床意义。     

良性前列腺增生症发生急性尿潴留的相关因素分析

目的:应用临床常用指标,探讨BPH发生急性尿潴留(AUR)的相关因素。方法:回顾分析538例BPH患者相关资料。分为曾发生AUR(A组)260例,从未发生AUR(B组)278例。分别比较两组间在年龄(AGE)、前列腺总体积(PV)、前列腺移行区体积(TZV)、移行区指数(TZI)和前列腺特异抗原(PSA)、游离前列腺特异抗原(F-PSA)、游离与总前列腺特异抗原比值(F/T-PSA)等指标上的差异性。结果:A组平均PV、TZV和PSA值皆明显高于B组,上述3个指标在两两组间差异有统计学意义,且PSA与PV、TZV均有正相关性。结论:PV、TZV及PSA可作为预测BPH发生AUR的良好指标。     

前列腺增生症患者膀胱逼尿肌中转化生长因子-β1和结缔组织生长因子的表达及临床意义

目的 探讨良性前列腺增生症(BPH)患者逼尿肌中转化生长因子-β1(TGF-β1)和结缔组织生长因子(CTGF)的表达及临床意义.方法 应用免疫组织化学SP法检测29例BPH患者膀胱逼尿肌标本中TGF-β1和CTGF的表达并检测平均吸光度(MA),依据各临床参数参考值进行分组比较.结果 所有标本均有不同程度的TGF-β1和CTGF表达.前列腺体积(PV)＞50 ml组与PV≤50 ml组患者逼尿肌中TGF-β1的表达差异无统计学意义(P＞0.05);而CTGF在PV＞50 ml组的表达量显著高于PV≤50 ml组(P＜0.01).TGF-β1和CTGF的表达量在移行区指数(TZI)＞0.65、残余尿量＞50 ml组患者逼尿肌中分别高于TZI≤0.65、残余尿量≤50 ml(P＜0.01),而与IPSS、Qmax和病程大小无明显相关(P＞0.05).Pearson积差相关分析可见TGF-β1与CTGF的表达呈正相关(r=0.761,P＜0.01).结论 逼尿肌中TGF-β1和CTGF的高表达与前列腺体积、移行区指数及残余尿量相关,提示这些临床参数可作为评估BPH患者膀胱逼尿肌纤维化程度的指标.

Abstract：

Objective To investigate the correlation between the expression of transforming growth factor-β1 (TGF-β1 ) , connective tissue growth factor ( CTGF) in the detrusor of benign prostatic hyperplasia (BPH) patients and its clinical significance. Methods Immunohistochemical SP method was used to detect the expression of TGF-β1 and CTGF in 29 specimens of bladder wall of BPH patients. All patients were divided into 2 groups according to the meaningful value of each clinical parameter to compare the expression of TGF-β1 and CTGF. Results All the samples had different levels of TGF-β1 and CTGF expression. The TGF-β1 in BPH patients whose prostate volume (PV) was＞50 ml was not significantly different from that in patients whose PV was ≤50 ml, but CTGF in BPH patients with PV ＞50 ml was higher than that in the other team. The TGF-β1 and CTGF in groups with TZI ＞0. 65 and residual urine＞50 ml were higher than other groups with TZI ≤0. 65 and residual urine ≤50 ml, respectively. The expression levels of TGF-β1 and CTGF of detrusors were not related with IPSS, Qmax, disease duration (P＞0. 05).Pearson-analysis reavealed that there was a positive correlation between the expression of TGF-β1 and CTGF in detrusors (r = 0. 761 ,P ＜0. 01). Conclusion TGF-β1 and CTGF have a strong correlation with PV, TZI and residual urine, suggesting that these clinical parameters may be useful in assessing the degree of the detrusor fibrosis in BPH patients.     

A new parameter in decision making for transurethral electroresection of benign prostate hyperplasia

OBJECTIVE: In this study, the clinical usefulness of transition zone (TZ) volume (TZV) measured by transrectal ultrasonography (TRUS) was investigated as a new parameter for the preoperative prediction of the treatment efficacy of transurethral resection of the prostate (TURP). METHODS: Fifty-six men with symptomatic benign prostatic hyperplasia (BPH; age 68.6 +/- 9.7 years) underwent TURP and were evaluated based on ordinary BPH parameters such as the international prostatic symptom score (I-PSS), quality of life (QOL) score, peak urine flow and entire prostate volume (PV), as well as the new TZV parameters and calculation of the TZ index. Relative risks were adjusted simultaneously for potentially confounding variables by multiple logistic regression analysis after adjustment for age, QOL, I-PSS, Qmax and residual urine. RESULTS: The adjusted relative risk for TURP at a TZ index of 0.1 increased to 4.5 (95% confidence interval 2.3-8.78). In general, poor responses were observed in patients with less symptomatic scores or lower values prior to operation, but there was a weak correlation between treatment outcome and preoperative scores or values of ordinary parameters. The volume parameters of BPH and PV did not predict treatment efficacy preoperatively, but TZV and the TZ index correlated with the treatment efficacy of TURP. CONCLUSION: TZV and the TZ index seem to be useful new parameters in preoperative decision-making with regard to TURP.     

良性前列腺增生症急性尿潴留的临床预测

目的 应用临床常用指标，预测良性前列腺增生(BPH)发生急性尿潴留(AUR)的几率。方法 回顾78名BPH患者病史，分为曾发生AUR(A组)28例，从未发生AUR(B组)50例。分别比较两组间在前列腺总体积(PV)、前列腺移行区体积(TZV)、移行区指数(TZI)和前列腺特异抗原(PSA)、游离前列腺特异抗原(F-PSA)、游离与总前列腺特异抗原比值(F/T-PSA)等指标上的差异性，寻找其中能用于预测AUR的临床指标。应用ROC曲线即受试者工作特性曲线，确定相关指标预测AUR的分界值。结果 A组平均PV、TZV和PSA值皆明显高于B组，上述3个指标在A、B两组间存在显著性差异。而A、B两组在年龄、TZI、F-PSA、F/T-PSA上都无显著性差异。在预测AUR方面PSA可能比前列腺体积指标更具临床价值。结论 可通过PV、TZV及PSA来预测BPH中AUR的发生。根据不同临床需要确定预测AUR的临界值，有利于及早对BPH高危人群进行监控和治疗干 预。     

Variations of transition zone volume and transition zone index after transurethral needle ablation for symptomatic benign prostatic hyperplasia

BACKGROUND: Transurethral needle ablation (TUNA) is less invasive than other therapies for benign prostatic hyperplasia (BPH) and produces coagulative necrosis within selected adenoma lesions. The action mechanism of TUNA is still obscure, even though many early studies have demonstrated good clinical results of TUNA. It is of interest and importance to know how TUNA influences the volume of the intraprostatic region responsible for bladder outlet obstruction in order to elucidate the anatomical action mechanism of TUNA. METHODS: We retrospectively investigated postoperative variations in volumetric parameters of whole prostate volume (PV), transition zone volume (TZV) and transition zone index (TZI = TZV/PV) in 41 patients with symptomatic BPH who were treated with TUNA. The data were analyzed statistically in relation to the preoperative overall severity and postoperative therapeutic efficacy. RESULTS: Both PV and TZV showed a significant decrease at 3 months after TUNA (P < 0.01) as did the symptom score, quality of life (QOL) score and functional variables, and a decreased level of PV and TZV was sustained until 12 months of follow-up when compared to the baseline (P < 0.01 at 6 months, not significant at 12 months). TZI also showed a similar pattern with a significantly decreased level until the postoperative 6th month (P < 0.05 at 6 months, not significant at 12 months). In 'moderate' cases, TZI achieved the minimum value (0.44 +/- 0.13, P < 0.05 compared to the baseline) at 3 months of follow-up, but the level immediately increased, while in 'severe' cases, TZI gradually decreased and achieved the minimum value (0.44 +/- 0.08, P < 0.05 compared to the baseline) at 12 months of follow-up. In the evaluation by postoperative therapeutic efficacy, there were no significant differences in PV, TZV and TZI between 'excellent and good' cases (E/G group) and 'fair and poor/worse' cases (F/P group) at the baseline or 3 months of follow-up. Both of the efficacy groups showed a significant decrease in PV, TZV and TZI at 3 months when compared to the baseline (P < 0.05). The mean decrease in TZI was significantly larger in the E/G group than in the F/P group (0.064 +/- 0.13 vs 0.027 +/- 0.12, P < 0.05). CONCLUSION: Therapeutic efficacy of TUNA did not depend on the baseline value of PV, TZV and TZI, but on variation of a decrease in TZI during follow-up. Moreover, a slow and lasting decrease in TZI seemed to influence durability of the therapeutic efficacy of TUNA, which was clearly observed in 'severe' cases with a larger prostatic volume than in 'moderate' cases.     

良性前列腺增生并发急性尿潴留相关因素分析

目的 :探讨血清前列腺特异抗原 (PSA)和移行带指数 (TZI)与良性前列腺增生 (BPH)并发急性尿潴留 (AUR)的关系。　方法 :回顾性分析 6 0 2例BPH患者的相关资料。　结果 :BPH并发AUR组血清PSA值为 (6 .6 0± 3.4 0 )μg/L ,TZI值为0 .71± 0 .14 ;未并发AUR组患者血清PSA值为 (3.5 1± 2 .30 ) μg/L ,TZI值为0 .4 6± 0 .2 1。两组间血清PSA和TZI值差异均有显著性 (P均 <0 .0 5 )。PSA <4 .0、4 .0～ 10 .0、>10 .0 μg/L 3组间AUR发生率进行比较 ,差异有显著性 (P均 <0 .0 5 ) ,AUR发生率随血清PSA值的增高而增高。血清PSA与TZI呈显著正相关 (r=0 .2 13,P <0 .0 1)。　结论 :血清PSA和TZI可作为预测BPH并发AUR的良好指标