非侵袭性检查指标对中老年男性膀胱出口梗阻的诊断价值

来源期刊：广州医药 | 16-20 发布时间：2021-12-02 收稿时间：2025/11/13 16:57:24 阅读量：13

作者：: 姜少军,

汤平,

韦兴华,

杨文俊,

谢克基,

王斌,

关键词：: 膀胱出口梗阻非侵袭性指标压力—流率测定; Bladder outlet obstruction Noninvasive parameters Pressure-flow study

DOI：: 10.3969/j.issn.1000-8535.2016.04.005

收稿时间：: 2016-04-07
修订日期：
接收日期：
引用总数：: 0

目的探讨临床常用非侵袭性检查指标诊断膀胱出口梗阻(BOO)的准确性及可靠性。方法回顾性研究2003年11月—2015年11月在广州市第一人民医院就诊并接受压力—流率测定(PFS)的男性LUTS/BPH患者,以侵袭性的PFS为诊断BOO的“金标准”,以前列腺体积(PV)、移行带体积(TZV)、移行带指数(TZI)、前列腺特异性抗原(PSA)、最大尿流率(Qmax)、剩余尿量(PVR)、剩余分数(RF)等非侵袭性检查指标为诊断指标进行诊断试验评价。结果筛选1319例患者纳入统计分析。以ICS列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR诊断BOO的ROC曲线下面积(AUC)分别为0.803、0.807、0.698、0.775、0.740、0.679、0.641;以Schaefer列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR诊断BOO的AUC分别为0.806、0.814、0.713、0.773、0.721、0.684、0.642。结论 PV、TZV、TZI、PSA、Qmax、RF、PVR等非侵袭性指标对筛查及诊断中老年男性BOO有一定的参考价值及临床意义,其中TZV、PV、PSA、Qmax的诊断准确性较高。

1、梁月有, 曹明欣, 戴宇平. 剩余分数在评价BPH所致膀胱出口梗阻中的临床意义 [J]. 临床泌尿外科杂志, 2006,(8): 612-613,615.

2、 OELKE M, HOFNER K, JONAS U, et al. Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume [J]. Eur Urol, 2007, 52(3): 827-834.

3、 ABDEL-AAL A, EL-KARAMANY T, AL-ADL AM, et al. Assessment of noninvasive predictors of bladder outlet obstruction and acute urinary retention secondary to benign prostatic enlargement [J]. Arab J Urol, 2011, 9(3): 209-214.

4、 LIM KB, HO H, FOO KT, et al. Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of bladder outlet obstruction [J]. Int J Urol, 2006, 13(12): 1509-1513.

5、 DE NUNZIO C, AUTORINO R, BACHMANN A, et al. The diagnosis of benign prostatic obstruction: Development of a clinical nomogram [J]. Neurourol Urodyn, 2014.

6、 KIM M, CHEETI A, YOO C, et al. Non-invasive clinical parameters for the prediction of urodynamic bladder outlet obstruction: analysis using causal Bayesian networks [J]. PLoS One, 2014, 9(11): e113131.

7、 VAN VENROOIJ GE, ECKHARDT MD, BOON TA. Noninvasive assessment of prostatic obstruction in elderly men with lower urinary tract symptoms associated with benign prostatic hyperplasia [J]. Urology, 2004, 63(3): 476-480.

8、 IDZENGA T, PEL JJ, VAN MASTRIGT R. Accuracy of maximum flow rate for diagnosing bladder outlet obstruction can be estimated from the ICS nomogram [J]. Neurourol Urodyn, 2008, 27(1): 97-98.

9、 KO YH, CHAE JY, JEONG SM, et al. Clinical Implications of Residual Urine in Korean Benign Prostatic Hyperplasia (BPH) Patients: A Prognostic Factor for BPH-Related Clinical Events [J]. Int Neurourol J, 2010, 14(4): 238-244.

10、 MCCONNELL JD, ROEHRBORN CG, BAUTISTA OM, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia [J]. N Engl J Med, 2003, 349(25): 2387-2398.

11、 ROEHRBORN CG, MCCONNELL JD, LIEBER M, et al. Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS Study Group [J]. Urology, 1999, 53(3): 473-480.

12、 LOWE FC, BATISTA J, BERGES R, et al. Risk factors for disease progression in patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH): a systematic analysis of expert opinion [J]. Prostate Cancer Prostatic Dis, 2005, 8(3): 206-209.

13、 ABRAMS P, CARDOZO L, FALL M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society[J]. Neurourol Urodyn, 2002, 21(2): 167-178.

14、 OELKE M, BAARD J, WIJKSTRA H, et al. Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia [J]. Eur Urol, 2008, 54(2): 419-426.

15、 GRATZKE C, BACHMANN A, DESCAZEAUD A, et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction [J]. Eur Urol, 2015, 67(6): 1099-1109.