Sonke Gabe S, Robertson Chris, Verbeek André L M, Witjes Wim P J, de la Rosette Jean J M C H, Kiemeney Lambertus A
Department of Urology, University Medical Center, Nijmegen, The, Nijmegen, Netherlands.
Urology. 2002 Mar;59(3):368-72. doi: 10.1016/s0090-4295(01)01547-3.
To investigate whether volume adjustment can be used to reduce the within-patient variability of the maximal urinary flow rate (Qmax) without affecting the variability between patients.
We analyzed 2049 urinary flow curves of 208 men with lower urinary tract symptoms suggestive of bladder outlet obstruction and studied the relation between Qmax and voided volume (VV) in individual patients using multilevel regression analysis.
In agreement with most previous studies, we found a hyperbolic relation between the VV and Qmax. Although hyperbolic on average, the slope of the regression line relating the VV to Qmax differed substantially across individual patients. In some patients, Qmax even tended to be lower with an increased VV.
The reproducibility of Qmax is poor, in part because of its dependence on the VV. The current methods to adjust Qmax for VV, such as the Siroky nomogram, minimize between-patient dependency, whereas our findings emphasize the importance of within-patient variability. A common approach to adjust Qmax for VV, however, is not feasible, because the relation of Qmax to VV differs substantially across patients. The only valid, although impractical option, remains to record a large number of urinary flow curves for each patient.
研究是否可通过容量调整来降低患者体内最大尿流率（Qmax）的变异性，同时不影响患者之间的变异性。
我们分析了208名有膀胱出口梗阻提示的下尿路症状男性的2049条尿流曲线，并使用多水平回归分析研究了个体患者中Qmax与排尿量（VV）之间的关系。
与大多数先前研究一致，我们发现VV与Qmax之间呈双曲线关系。虽然总体上呈双曲线关系，但个体患者中VV与Qmax之间回归线的斜率差异很大。在一些患者中，随着VV增加，Qmax甚至趋于降低。
Qmax的可重复性较差，部分原因是其依赖于VV。当前针对VV调整Qmax的方法，如西罗基列线图，可将患者间的依赖性降至最低，而我们的研究结果强调了患者体内变异性的重要性。然而，一种通用的针对VV调整Qmax的方法并不可行，因为Qmax与VV之间的关系在不同患者中差异很大。唯一有效的方法，尽管不切实际，仍然是为每位患者记录大量尿流曲线。
Zotero 插件