经会阴超声在不同程度压力性尿失禁分级诊断中的应用价值

目的分析经会阴超声在不同程度压力性尿失禁（SUI）诊断中的应用价值。 方法选取2016年9月至2019年2月在华北理工大学附属医院就诊的SUI女性患者为病例组（其中56例轻度患者、48例中度患者、30例重度患者），选择同期因健康体格检查就诊后排除SUI的女性40名为健康对照组，对上述女性行经会阴超声检查，测量膀胱颈在X轴后移的距离（ΔDx）、在Y轴下移的距离（ΔDy）、移动度（Mu）和旋转角度（θ），采用方差分析比较组间上述指标的差异，并构建不同程度SUI患者上述指标的ROC曲线，初步确定不同程度SUI诊断界值。 结果4组间比较，ΔDx、ΔDy、Mu、θ值差异均有统计学意义（P均<0.05），且随着SUI严重程度的增加呈增加趋势。经过ROC曲线分析，ΔDy、Mu、θ值诊断SUI的界值、敏感度、特异度分别为10.56 mm、55.2%、97.5%；11.66 mm、80.6%、90.5%；24.18°、82.1%、92.5%；ΔDx、ΔDy、Mu、θ值诊断中重度SUI的界值、敏感度、特异度分别为6.31 mm、50.0%、88.8%；10.64 mm、68.4%、78.6%；12.75 mm、97.4%、75.5%；28.85°、84.2%、84.7%；ΔDy、Mu、θ值诊断重度SUI的界值、敏感度、特异度分别为9.36 mm、86.7%、59%；15.09 mm、93.3%、88.2%；34.75°、90.0%、86.1%。 结论经会阴超声检查在SUI的诊断中具有重要的应用价值，其中Mu、θ值对SUI及其严重程度的诊断意义较大，有望作为临床诊断轻、中、重度SUI的参考指标。

Value of transperineal ultrasonography in grading diagnosis of different degrees of stress urinary incontinence

Objective To evaluate the value of transperineal ultrasonography in the grading diagnosis of stress urinary incontinence(SUI)of different degrees.Methods The SUI patients who were hospitalized at the Affiliated Hospital of North China University of Science and Technology were selected as a study group from September 2016 to February 2019(56 mild patients,48 moderate patients,and 30 severe patients),and 40 patients who were confirmed as having no SUI after health examination were selected as a control group.All subjects were examined by transperineal ultrasonography to measure the distance of backward moving of the bladder neck in X-axis(ΔDx),the distance of downward moving of the bladder neck in Y axis(ΔDy),the mobility of the bladder neck(Mu),and the rotation angle of the bladder neck(θ).The above parameters were analyzed and compared by analysis of variance,and the receiver operating characteristic(ROC)curves of these parameters were plotted for SUI patients of different degrees to determine their diagnostic thresholds.Results The differences ofΔDx,ΔDy,Mu,andθamong the four groups were statistically significant(P<0.05),and showed an increasing trend with the increase of SUI severity.ROC curve analysis showed that the cutoff values,sensitivities and specificities ofΔDy,Mu,andθfor diagnosing SUI were 10.56 mm,55.2%,97.5%;11.66 mm,80.6%,90.5%;24.18°,82.1%,92.5%,respectively.The cutoff values,sensitivities and specificities ofΔDx,ΔDy,Mu,andθfor diagnosing moderate and severe SUI were 6.31 mm,50.0%and 88.8%;10.64 mm,68.4%and 78.6%;12.75 mm,97.4%and 75.5%;28.85°,84.2%and 84.7%,respectively.The cutoff values,sensitivities and specificities ofΔDy,Mu,andθfor diagnosing severe SUI were 9.36 mm,86.7%and 59%;15.09 mm,93.3%and 88.2%;34.75°,90.0%and 86.1%,respectively.Conclusion Transperineal ultrasonography plays an important role in the diagnosis of SUI,and Mu andθvalues are of great significance in the diagnosis of SUI and evaluating its severity,and could be used as diagnostic parameters for SUI.