摘要
目的通过对老年良性前列腺增生（BPH）患者逼尿肌厚度与膀胱出口梗阻的相关性研究，探讨超声测量逼尿肌厚度预测老年男性膀胱出口梗阻的价值。方法130例老年患者行尿动力学检查，以尿动力学检查结果作为膀胱出口梗阻的诊断依据，梗阻标准：Abrams—Griffiths（A—G）指数≥40，LinPURR梗阻分级≥Ⅱ级。经腹B超在膀胱充盈至最大限度时测定逼尿肌厚度。结果最大尿流率和平均尿流率梗阻组[（8．0±2．0）ml／s、（4．2±1．8）ml／s]均明显低于非梗阻组[（16．5±2．5）ml／s、（10．2±1．9）ml／s]（P〈0．05），而残余尿量、逼尿肌最大收缩压力梗阻组[（87．5±20．3）ml、（49．3±16．4）cmH2O]高于非梗阻组[（10．6±5．5）ml、（35．8±10．0）cmH2O]（P〈0．05）。逼尿肌厚度与逼尿肌最大收缩压力呈正相关（P〈0．05），与最大尿流率（P〈0．05）、平均尿流率（P〈0．05）和排尿量（P〈0．05）呈负相关。逼尿肌厚度梗阻组（3．1±0．1）mm高于非梗阻组（2．6±0．1）mm（P〈0．05）。以逼尿肌厚度≥3．1mm为标准诊断男性下尿路梗阻的敏感性为92％，特异性为93％，阳性预测值93．5％，阴性预测值为65．2％。结论膀胱出口梗阻患者逼尿肌厚度增加，收缩功能随着梗阻程度加重而增加，逼尿肌厚度大于3．1mm可以在一定程度上预测老年男性膀胱出口梗阻。
Objectives To evaluate the relationship between ultrasound - assayed detrusor thickness and bladder outlet obstruction（BOO） in old men with benign prostatic hyperplasia（BPH）. Methods The 130 old patients underwent the urodynamic examination on which the diagnosis of BOO was dependent. The obstruction was defined as the Abrains - Griffiths nomogram （ A - G index） ≥40 and the grade of linear passive urethraI resistance relation（LinPURR） ≥ II. When bladder max capacity was reached. the detrusor thickness was measured by alxlominal ultrasound. Results Compared with unobstructed group, the maximum flow rate and average flow rate were both lower in obstructed group [ （8.0 ± 2.0） ml/s vs. （ 16.5 ± 2.5 ） ml/s, （4.2 ± 1.8 ） ml/s vs. （ 10.2 ± 1.9 ） ml/s, both p 〈0.05 ]. And the residual urine volume and maximum detrusor pressure were significantly higher in obstructed group than in unobstructed group [ （ 87.5 ± 20.3 ） ml vs. （ 10.6 ± 5.5 ） ml, （49.3 ± 16.4 ） cmH2O vs. （ 35.8 ± 10. 0 ） cmH2O, both p 〈 0.05 ]. Detrusor thickness was positively correlated with maximum detrusor pressure （ CB p 〈 0. 05 ）, but negatively correlated with maximum flow rate（ p 〈 0.05 ）. mean flow rate（ p 〈 0.05 ）and voided volume（ p 〈0.05 ）. There was significant difference indetrusor thickness between obstructed group and unobstructed group [ （3.1 ± 0.1 ） mm VS. （2.6 ± 0.1 ） mm, p 〈 0.05. According to the diagnostic standard of detrusor thickness ：≥3. 1 mm,it had a sensitivity of 92% and a specificity of 93 %, a positive predictive value of 93.5 % and a negative predictive vatue of 65.2%. Conclusions Detrusor thickness of 3.1 mm or greater has a certain predictive value for BOO in old men.
出处
《国际泌尿系统杂志》
2011年第4期446-449,共4页
International Journal of Urology and Nephrology
关键词
前列腺增生
Prostatic Hyperptasia
