静态尿道压力图对良性前列腺增生所致膀胱出口梗阻的诊断价值.docVIP

静态尿道压力图对良性前列腺增生所致膀胱出口梗阻的诊断价值 杨星亮，赵 江，冯观贵，于 伟，李龙坤 (400038 重庆，第三军医大学新桥医院泌尿外科) [摘要] 目的 探讨静态尿道压力图(resting urethral pressure profile，RUPP)在评价良性前列腺增生（benign prostatic hyperplasiat，BPH）所致的膀胱出口梗阻中的诊断价值。方法 回顾性分析2011年8月至2013年8月内我院收治的119例BPH患者的尿动力学资料，依据压力流率同步测定结果分别分为无梗阻组、可疑梗阻组、梗阻组。分别比较3组间RUPP指标的差异，并通过多因素Logistic回归分析建立函数模型，运用受试者工作曲线（ROC曲线）分析比较回归模型及各个指标诊断膀胱出口梗阻（bladder outlet obstruction，BOO）的价值。结果 梗阻组的膀胱颈压、精阜压、前列腺长度、功能曲线长度、前列腺平台面积均显著大于无梗阻组，而最大尿道压和最大尿道闭合压组间则无统计学差异；多元Logistic回归分析中，前列腺平台面积和精阜压进入模型，经ROC曲线比较，联合指标对于梗阻的诊断价值明显高于其他指标（ACU为0.968），而单一指标中则以前列腺平台面积(prostatic plateau area ,PPA)的ROC曲线下面积最具诊断价值（AUC为0.893）。结论 RUPP参数可用于诊断BPH所致膀胱出口梗阻，且特别适用于不能进行压力-流率测定(pressure-uroflow studies, P/Q)患者尿道梗阻情况的评价，参数中回归模型的诊断效力最佳。 [关键词] 静态尿道压力测定;良性前列腺增生;膀胱出口梗阻; 诊断 [中图法分类号] [文献标志码] A Role of resting urethral pressure profile in diagnosing of bladder outlet obstruction due to benign prostatic hyperplasiat Yang Xingliang, Zhao Jiang, Feng Guangui, Yu wei, Li Longkun （Department of Urology，Xinqiao Hospital，Third Military Medical University，Chongqing 400037，China） [Abstract] Objective To investigate the value of resting urethral pressure profile (RUPP) in the diagnosis of bladder outlet obstruction (BOO) due to benign prostatic hyperplasiat (BPH). Methods Urodynamic and clinical data of 119 patients with BPH between August 2011 and August 2013 were analyzed retrospectively. According to pressure-uroflow study (P/Q), patients were divided into three groups: Obstructed, equivocal obstructed and unobstructed, and the parameters of RUPP among different groups were compared. The multivariate logistic regression analysis was used to establish a regression model. Meanwhile, the ROC curves were used to investigate the value of different RUPP index and the regression model in assessing BOO due to BPH. Results Most parameters on RUPP in obstructed group were significant higher than those in unobstructed group, such as prostatic length, functional profile length, pressure