应用膀胱出口梗阻指数预测良性前列腺增生所致膀胱出口梗阻

[Applying bladder outlet obstruction number to predict bladder outlet obstruction of benign prostatic hyperplasia].

作者信息

Zhang Peng, Wu Zhi-jin, Yang Yong, Zhang Xiao-dong

机构信息

Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Aug 1;46(15):1156-9.

PMID:19094679

Abstract

OBJECTIVE

Applying bladder outlet obstruction number (BOON) to predict bladder outlet obstruction (BOO) of benign prostatic hyperplasia (BPH).

METHODS

Seventy-six male who were suspected to suffer from BOO due to BPH with lower urinary tract symptoms were evaluated. The data included prostate volume (by transrectal prostate ultrasound), maximum urine flow rate (Qmax) and mean voided volume to calculate the BOON by simple algorithm: prostate volume (cm(3))-3 x Qmax (ml/s)-0.2 x mean voided volume (ml). Pressure-flow study was also performed on each patient to get AG number and Schäfer obstruction grade. Correlation between traditional parameters, BOON and AG number was calculated to evaluate the price of using BOON to predict BOO.

RESULTS

Parameters such as age, prostate volume, maximum urine flow rate, residual urine and BOON were used as independent and AG was used as dependent to calculated the multiple linear regression. Data expressed the entire regression equation's R = 0.542 (P = 0.000), and result showed BOON had the strongest relationship with AG (P = 0.000). Eighteen patients' BOON number were greater than -10, by AG number and Schäfer obstruction grade proving, all these patients were suffered from BOO, the sensitivity and the specificity of judging BOO by BOON were 31% and 100% respectively. While take BOON as -20, the sensitivity and the specificity were 42.4% and 88.2%, when take BOON as -30, the sensitivity and the specificity were 66.1% and 82.4%, respectively. Fifty-two persons' BOON were greater than -40, 46 patients suffered from BOO, the sensitivity and the specificity were 77.9% and 64.7%, the specificity and the opportunity of having BOO decreased significantly. The data showed that: taking BOON = -30 as critical point can predict BOO with higher sensitivity and specificity, greater BOON means greater possibility of BOO.

CONCLUSIONS

Using BOON which is deduced from prostate volume, maximum urine flow rate and mean voided volume, the point -30 as critical point, can predict the probability of BOO with higher sensitivity and specificity.

摘要

目的

应用膀胱出口梗阻数值（BOON）预测良性前列腺增生（BPH）所致膀胱出口梗阻（BOO）。

方法

对76例因BPH伴下尿路症状而疑似患有BOO的男性患者进行评估。数据包括前列腺体积（经直肠前列腺超声测量）、最大尿流率（Qmax）和平均排尿量，通过简单算法计算BOON：前列腺体积（cm³）-3×Qmax（ml/s）-0.2×平均排尿量（ml）。还对每位患者进行了压力-流率研究以获得AG数值和施费尔梗阻分级。计算传统参数、BOON与AG数值之间的相关性，以评估使用BOON预测BOO的价值。

结果

将年龄、前列腺体积、最大尿流率、残余尿量和BOON等参数作为自变量，AG作为因变量进行多元线性回归计算。数据显示整个回归方程的R = 0.542（P = 0.000），结果表明BOON与AG的关系最为密切（P = 0.000）。18例患者的BOON数值大于-10，经AG数值和施费尔梗阻分级证实，所有这些患者均患有BOO，BOON判断BOO的敏感性和特异性分别为31%和100%。当以BOON为-20时，敏感性和特异性分别为42.4%和88.2%，当以BOON为-30时，敏感性和特异性分别为66.1%和82.4%。52例患者的BOON大于-40，其中46例患有BOO，敏感性和特异性分别为77.9%和64.7%，特异性和患BOO的可能性显著降低。数据表明：以BOON = -30为临界点可较高敏感性和特异性地预测BOO，BOON越大，患BOO的可能性越大。