摘要
目的探讨前列腺增生(BPH)患者钬激光前列腺剜除术(HoLEP)后发生下尿路功能障碍(LUTS)的影响因素,并基于这些因素构建预测模型。方法回顾性收集2021年2月~2024年2月于首都医科大学附属北京友谊医院平谷医院接受治疗的98例BPH患者的临床资料,根据患者术后是否发生LUTS将其分为障碍组(n=31)和非障碍组(n=67)。采用多因素logistic回归模型分析BPH患者HoLEP术后发生LUTS的影响因素,并通过受试者工作特征(ROC)曲线评估各指标单独及联合检测的预测价值。结果两组患者的体质量指数(BMI)、糖尿病情况、术前国际前列腺症状评分(IPSS)、C反应蛋白(CRP)水平、尿蛋白定性情况、黏液便情况、总蛋白(TP)水平、白蛋白(ALB)水平、球蛋白(GLO)水平、前列腺特异性抗原(PSA)含量、前列腺总体积(TPV)、前列腺突入膀胱(IPP)、阻力指数(RI)、排尿时间(DWT)、最大尿流率时的逼尿肌压力(Pdet Qmax)、最大尿流率(Qmax)比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,CRP水平、PSA含量、TP、ALB水平、Qmax均是BPH患者HoLEP后LUTS发生的独立预测因素(P<0.05)。ROC曲线分析结果显示,CRP、PSA、TP、ALB、Qmax及联合指标预测BPH患者HoLEP术后发生LUTS的AUC分别为0.789、0.795、0.814、0.761、0.811,对应的灵敏度分别为87.59%、66.37%、83.88%、66.10%、88.69%,特异度分别为60.32%、83.74%、68.51%、83.14%、62.54%,以上指标联合的AUC为0.973,灵敏度91.02%,特异度91.17%。结论CRP、PSA、TP、ALB、Qmax是BPH患者HoLEP后LUTS发生的独立预测因素,本研究构建的预测模型具有一定的临床应用价值,能够为临床医生提供科学的术前评估工具。
Objective To analyze the influencing factors of urinary tract dysfunction in patients with benign prostatic hyperplasia(BPH)after holmium laser enucleation(HoLEP),and to build a prediction model based on these factors.Methods The clinical data of 98 BPH patients who underwent HoLEP in Beijing Friendship Hospital Pinggu Campus from February 2021 to February 2024 were selected retrospectively analyzed.According to whether the patients had lower urinary tract dysfunction after operation,they were divided into obstacle group(n=31)and non-obstacle group(n=67).Multivariate Logistic regression was used to analyze the influencing factors of urinary tract dysfunction after operation,and ROC curve was used to evaluate the predictive value.Results The results showed that there were statistically significant differences between the two groups in body mass index(BMI),diabetes status,preoperative International Prostate Symptom Score(IPSS),C-reactive protein(CRP)levels,qualitative urine protein,presence of mucous stool,total protein(TP)levels,albumin(ALB)levels,globulin(GLO)levels,prostate-specific antigen(PSA)levels,total prostate volume(TPV),intravesical prostatic protrusion(IPP),resistance index(RI),detrusor wall thickness(DWT),detrusor pressure at maximum flow rate(Pdet Qmax),and maximum flow rate(Qmax)(P<0.05).Logistic multivariate analysis showed that CRP,PSA,TP,ALB and Qmax were independent predictors of lower urinary tract dysfunction in BPH patients after HoLEP.The ROC results showed that the AUC of CRP,PSA,TP,ALB and Qmax for lower urinary tract dysfunction in BPH patients after HoLEP was 0.789,0.795,0.814,0.973,0.811 and 0.761,respectively,and the corresponding sensitivity was 87.59%and 66.37%.Conclusion CRP,PSA,TP,ALB and Qmax are independent predictors of lower urinary tract dysfunction in BPH patients after HoLEP.The prediction model constructed in this study has certainly clinical application value and can provide clinicians with scientific preoperative evaluation tools.
作者
王超
曲直
李海立
张立文
李晨曦
杨立军
Wang Chao;Qu Zhi;Li Haili;Zhang Liwen;Li Chenxi;Yang Lijun(Department of Urology,Beijing Friendship Hospital Pinggu Campus,Capital Medical University,Beijing 101200,China)
出处
《中华保健医学杂志》
2025年第3期377-381,共5页
Chinese Journal of Health Care and Medicine
基金
平谷区卫计委科研项目(Pgwjw2018-06)
平谷区医院科研项目(pgyy-2024-10)。
关键词
前列腺增生
钬激光
前列腺剜除术
尿路功能障碍
影响因素
Prostatic hyperplasia
Holmium laser
Prostate enucleation
Urinary tract dysfunction
Influencing factor
