症状性前列腺增生剩余尿及最大尿流率的临床价值再探讨

Reevaluation of postvoid residual urine and maximum flow rate in men with symptomatic benign prostatic hyperplasia

目的:探讨症状性前列腺增生剩余尿(PVR)、最大尿流率(Qmax)在临床诊疗中的作用。方法:对173例BPH患者进行IPSS评分、并测定Qmax、PVR及前列腺体积。应用相关分析评价各检变量间的相关性及其不同组间各指标的比较。结果:PVR与IPSS、前列腺移行带体积均呈正相关,与Qmax呈负相关。与年龄、前列总腺体积之间均无相关(P>0.05)。PVR<10ml组与10～30ml组在年龄、IPSS、前列腺移行带体积和Qmax比较差异均无统计学意义。PVR10～30ml组与≥30ml组在年龄、前列腺移行带体积比较差异均无统计学意义,而IPSS、Qmax比较差异有统计学意义。在Qmax<10ml/s组,Qmax与年龄、IPSS、PVR、前列腺总体积和前列腺移行带体积均呈负相关;在Qmax>10ml/s组,Qmax与上述指标均呈无相关(P>0.05);除年龄外,两组间上述指标均有显著的统计学意义(P<0.001)。结论:症状性BPH患者PVR≥30ml,Qmax<10ml/s时,在排除其他因素引起逼尿肌损害所致的PVR增加及Qmax降低后,应及早解除膀胱出口梗阻。

Objective：To evaluate the postvoid residual urine （PVR） and maximum flow rate （Qmax） in an population of men with benign prostate hyperplasia （BPH） accompanied by lower urinary tract symptoms （LUTS）, and to assess the correlation between PVR, Q urinary symptoms, prostate volum and age, and compare the difference of them in various groups. Methods： A total of 173 men with symptomatic BPH were investigated using the International Prostate Symptom Score （IPSS）, and the measurement of urinary flow rate and the prostate volume. Correlalion analysis was conducted to determine the correlation among the variables. These variables in different groups were compared. Results： The mean age of the patients was （67.47±5.67） years, the mean IPSS score was （21.01±4.61）, the mean PVR was （26.25±33.66）, the mean Qmax was （10.09±3.08）, the mean total prostate volume （PV）was （41.38±21.29） and the mean transition zone volume （TZV） was （24.45±16.77）. There was statislieally positive correlation between PVR and age （γ= 0. 162, P = 0. 033 ）, IPSS scores （γ= 0.286, P=0.000）, TZV （γ=0. 193, P=0.011）, negatively eorrelate to Qmax（γ=0.308, P= 0.000）, but did not to PV（P〉0.05）. In PVR〈 10 ml group and PVR= 10～30 ml group, there were no statistically significant differences between the two groups in age , IPSS score, TZV and Qmax In PVR= 10～30 ml group and PVR ≥30 ml group, there were stalistieally signifieanl difference in IPSS score and Qmax There was no obvious difference in age and TZV. In the group of Qmax 〈10 ml/s, there was statistically negative correlalion between Qmax and age （γ=- 0.307,P= 0.002）, IPSS seores （γ=- 0.285, P= 0.004）, PVR（γ=-0.313, P=0. 001）, PV （γ=-0. 267, P=0. 006） and TZV （γ=-0. 304, P=0. 004）. In the group of Qmax〉10 ml/s, Qmax did not correlate to them. （P〉O. 05）. There were statistically significant differences between the two groups in IPSS score, PVR, Qmax PV and TZV. Conclusions： The men with PVR≥30 ml and Qmax〈10 ml/s in benign prostate hyperplasia （BPH） accompanied by lower urinary tract symptoms （I.UTS） should be treated with surgery as soon as possible