经直肠超声评价前列腺突人膀胱致膀胱出口梗阻的研究

Transrectai ultrasound in assessment of bladder outlet obstruction via intravesicai prostatic protrusion

目的：评价经直肠超声（TRUS）在良性前列腺增生突入膀胱致膀胱出口梗阻（BOO）诊断中的价值。方法：选择具有下尿路症状且前列腺体积＞30cm^3的良性前列腺增生患者110例，应用灰阶TRUS测得前列腺增生突入膀胱的大小（IPP）、IPP与前列腺纵径的比值（IPPR）及其他形态学参数；应用能量多普勒超声检测前列腺动脉的血流阻力指数。应用尿动力学检查仪的压力一流率曲线测得AG值。根据尿动力学检查结果将TRUS所测指标做逻辑回归分析。结果：通过建立逻辑回归方程，BOO的主要相关因素为IPPR和内外腺交界处包膜动脉的血流阻力指数（CRI），此方程预测BOO的阳性率87．5％，阴性率73．9％，准确率为81．8％。结论：IPPR与CRI可以作为TRUS评价前列腺增生突入膀胱致BOO有意义的指标。

Objective To assess the significance of transrectal ultrasonography for the diagnosis of bladder outlet obstruction （BOO） due to benign prostatic hyperplasia via intravesical prostatic protrusion（IPP）. Methods The data of 110 patients with lower urinary symptoms and the prostate volume above 30 cm^3 were enrolled. The IPP,the ratio between IPP and the vertical length of the prostate（IPPR） and other morphologic parameters were measured. The resistive indices（RI） of the prostate arteries were detected by transrectal power Doppler. The Abrams-Griffths（AG） number were determined by urodynamics. The logistic regression with the transrectal variables according to the AG value was analyzed. Results By the logistic regression, the main factors of BOO were IPPR and the RI of capsular artery（CRI）. The logistic regression model predicted that the IPPR and CRI measured by TRUS provide important positive BOO prediction rate of 87.5% ,negative prediction rate of 73.9% and accuracy of 81.8%. Conclusions IPPR and CRI are meaningful indices for BOO diagnosised.