B型超声与尿动力学参数建立经尿道前列腺电切术疗效预测模型的效力比较

目的探讨B超可否取代尿动力学作为经尿道前列腺电切术(TURP)前筛选检查。方法前瞻性纳入良性前列腺增生(BPH)患者285例。评估患者术前下尿路症状(LUTS)及生活质量(QOL),并给予B超及尿动力学联合检查。TURP术后6个月从症状、生活质量及最大尿流率(Qmax)恢复程度三方面评估手术疗效。利用B超及尿动力学参数作为自变量建立Fisher判别模型,绘制受试者工作特征(ROC)曲线并对模型预测TURP疗效的能力做出比较。结果两个模型均具有良好的敏感度、特异度、阳性以及阴性预测值。两个模型ROC曲线下面积(AUC)分别为0.779及0.808,Z检验提示模型间预测效力差异无统计学意义(Z=0.648,P=0.517)。结论术前B超和尿动力学检查在预测TURP疗效方面均具有良好效力,B超有望取代尿动力学作为筛选BPH手术患者的无创性检查。

The effect comparison of the predictive models of transurethral resection of prostate between ultrasonography and urodynamics

Objective To explore the feasibility of ultrasonography to replace urodynamics as screening inspection before transurethral resection of prostate（ TURP）. Method Two hundreds and eighty five patients with benign prostatic hyperplasia（ BPH） was prospectively collected. All the subjects had preoperative evaluation of lower urinary tract symptoms（ LUTS）,quality of life（ QOL）,and combined examination of ultrasonography and urodynamics. Surgical efficacy was evaluated according to the recovery of international prostate symptom score（ IPSS）,QOL score,and maximal flow rate（ Qmax） at 6 months after TURP. Fisher＇s linear discriminant analysis was applied to establish the predictively models of surgical efficacy by choosing parameters from ultrasonography or urodynamics as independent factors. Receiver＇s operating characteristic（ ROC） curve was plotted to compare the values between two models. Results The predictive value of sensitivity,specificity,positive and negative of 2 models were both favorable. The area under curve（ AUC） of 2 models were 0. 779 and 0. 808 respectively,no significant difference between them（ Z = 0. 648,P = 0. 517）. Conclusion Preoperative ultrasound and urine dynamics test has a good predictive effect in TURP curative effect,and ultrasound is expected to replace the urine dynamics as a noninvasive test in screening of BPH surgery patients.