Department of Urology, Beijing ChaoYang Hospital, Capital Medical University, Beijing, China.
Urology. 2013 Nov;82(5):1098-102. doi: 10.1016/j.urology.2013.06.019. Epub 2013 Jul 31.
To investigate the feasibility and accuracy of the diagnosis of bladder outlet obstruction (BOO) in men using near-infrared spectroscopy (NIRS) as a noninvasive monitor.
The study included 94 patients with lower urinary tract symptoms owing to benign prostatic hyperplasia. All patients underwent uroflow rate and post-void residual (PVR) followed by NIRS assessment of BOO and pressure-flow study for diagnosis. The results of the NIRS were compared with that of the pressure-flow study.
The data of 87 patients were finally enrolled in this study. According to the BOO judged by the NIRS, the 87 patients were divided into an obstruction group (52 cases) and a nonobstruction group (35 cases). The differences in the Abrams-Griffiths number, the linear passive urethral resistance relation value, and urethral resistance factor value between the 2 groups were significant (P ≤.001), indicating the practical significance of the NIRS method in the diagnosis of BOO. Further analysis showed the following: (1) the NIRS has a sensitivity of approximately 68.3%, specificity of 62.5%, and average diagnosis coincidence rate of 66.7% compared with the "gold standards"-Abrams-Griffiths number, and (2) the sensitivity (68.3%) and the coincidence rate (66.7%) of the NIRS diagnosis for BOO were significantly higher than the sensitivity (33.3%) and the coincidence rate (48.3%) of the examination method of free uroflow rate + PVR.
Compared with the "maximum uroflow rate (Qmax) + PVR", NIRS can be more accurate and noninvasive for the diagnosis of BOO in men; this approach provides a new noninvasive method of high clinical value.
探讨近红外光谱(NIRS)作为一种非侵入性监测手段,诊断男性膀胱出口梗阻(BOO)的可行性和准确性。
本研究纳入了 94 例因良性前列腺增生而出现下尿路症状的患者。所有患者均行尿流率和残余尿量(PVR)检查,然后行 NIRS 评估 BOO 并进行压力-流率研究以明确诊断。将 NIRS 结果与压力-流率研究结果进行比较。
本研究最终纳入 87 例患者的数据。根据 NIRS 判断的 BOO 结果,将 87 例患者分为梗阻组(52 例)和非梗阻组(35 例)。2 组患者的 Abrams-Griffiths 数、线性被动尿道阻力关系值和尿道阻力因子值差异均有统计学意义(P ≤.001),提示 NIRS 方法在 BOO 诊断中具有实际意义。进一步分析显示:(1)NIRS 与“金标准”Abrams-Griffiths 数相比,具有约 68.3%的灵敏度、62.5%的特异性和 66.7%的平均诊断符合率;(2)NIRS 诊断 BOO 的灵敏度(68.3%)和符合率(66.7%)明显高于自由尿流率+PVR 检查方法的灵敏度(33.3%)和符合率(48.3%)。
与“最大尿流率(Qmax)+PVR”相比,NIRS 能更准确、更无创地诊断男性 BOO,为临床提供了一种具有较高应用价值的新的无创方法。