Su Z Y, Liu H M, Tian Y, Yang B, Luo G H
Guizhou Medical University, Guiyang 550004 China.
Department of Urology, People's Hospital affiliated to Guizhou Medical University, Guiyang 550002, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 18;100(6):452-455. doi: 10.3760/cma.j.issn.0376-2491.2020.06.011.
To investgate the effect of properative transitional zone index (TZI) on the outcome of transurethral resection of prostate (TURP). A retrospective analysis was performed on 206 patients with TURP who were admitted to our hospital from January 2016 to September 2018. All patients underwent transrectal ultrasound (TRUS) to determine the total prostate volume (TPV) and the transition zone volume (TZV). Patients were divided into two groups according to TZI (TZV/TPV) (group A: TZI<0.5, group B: TZI≥0.5). We collected data 6-months after surgery including international prostate symptom score (IPSS), quality of life score (QOL), maximum flow rate (Qmax), and postvoiding residue (PVR) to compare the difference of the postoperative outcome of two groups, while the IPSS was subdivided into voiding (IPSS-v) and storage(IPSS-s) symptoms, and the changes of IPSS, IPSS-v, IPSS-s, QOL, Qmax and PVR before and after surgery were analyzed. The treatment efficacy was determined as the changes of IPSS (post/preoperative IPSS: %IPSS), QOL (preoperative QOL-postoperative QOL: ΔQOL) and Qmax(preoperative Qmax-postoperative Qmax: ΔQmax). Pearson linear correlation analysis was employed to estimate the correlation of TZI and %IPSS, ΔQOL and ΔQmax, respectively. A total of 126 patients were in Group A, and 80 patients were in group B. 1. The preoperative clinical data of the two groups were compared. There were no significant differences regarding age, IPSS, IPSS-v, IPSS-s, QOL, Qmax, and PVR between two groups (all 0.05). However, the TPV of patients in group B (74.57±29.25) ml was significantly larger than that in group A (46.25±24.56) ml, 0.001. While the postoperative follow-up outcomes of the two groups were compared, we found that IPSS-s (0.079), QOL (0.710), and PVR (0.651) were not statistically different between the two groups, but the postoperative IPSS, IPSS-v, and Qmax (8.50±5.75 vs 6.38±4.36, 4.03±3.75 vs 2.63±2.5, and (16.54±4.43) ml/s vs (18.94±4.84) ml/s, all 0.05) were significantly different between the two groups. 2. Postoperative IPSS, IPSS-v, IPSS-s, QOL, Qmax and PVR were significantly different from those before surgery in two groups, respectively. 3. Pearson linear correlation analysis showed a significant positive correlation between TZI and ΔQmax (0.32, 0.01), a weaker negative correlation between TZI and %IPSS (-0.22, 0.01), and no correlation between TZI and ΔQOL (0.08, 0.238). There may be a correlation between the outcome of TURP and TZI, and the outcome of TURP may be better in patients with TZI ≥ 0.5.
探讨前列腺移行区指数（TZI）对经尿道前列腺电切术（TURP）疗效的影响。对2016年1月至2018年9月我院收治的206例行TURP的患者进行回顾性分析。所有患者均接受经直肠超声（TRUS）检查以确定前列腺总体积（TPV）和移行区体积（TZV）。根据TZI（TZV/TPV）将患者分为两组（A组：TZI<0.5，B组：TZI≥0.5）。我们收集了术后6个月的数据，包括国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）和残余尿量（PVR），以比较两组术后疗效的差异，同时将IPSS细分为排尿（IPSS-v）和储尿（IPSS-s）症状，并分析手术前后IPSS、IPSS-v、IPSS-s、QOL、Qmax和PVR的变化。治疗效果通过IPSS（术后/术前IPSS：%IPSS）、QOL（术前QOL-术后QOL：ΔQOL）和Qmax（术前Qmax-术后Qmax：ΔQmax）的变化来确定。分别采用Pearson线性相关分析评估TZI与%IPSS、ΔQOL和ΔQmax的相关性。A组共126例患者，B组80例患者。1. 比较两组患者术前临床资料。两组患者在年龄、IPSS、IPSS-v、IPSS-s、QOL、Qmax和PVR方面均无显著差异（均P>0.05）。然而，B组患者的TPV（74.57±29.25）ml显著大于A组（46.25±24.56）ml，P<0.001。比较两组术后随访结果，我们发现两组患者的IPSS-s（P=0.079）、QOL（P=0.710）和PVR（P=0.651）无统计学差异，但两组患者术后的IPSS、IPSS-v和Qmax（8.50±5.75 vs 6.38±4.36，4.03±3.75 vs 2.63±2.5，以及（16.54±4.43）ml/s vs（18.94±4.84）ml/s，均P<0.05）有显著差异。2. 两组患者术后的IPSS、IPSS-v、IPSS-s、QOL、Qmax和PVR分别与术前有显著差异。3. Pearson线性相关分析显示，TZI与ΔQmax呈显著正相关（r=0.32，P=0.01），TZI与%IPSS呈较弱的负相关（r=-0.22，P=0.01），TZI与ΔQOL无相关性（r=0.08，P=0.238）。TURP的疗效可能与TZI有关，TZI≥0.5的患者TURP疗效可能更好。
