尿流加速度和最大尿流率诊断膀胱出口梗阻的价值

Clinical value of urine flow acceleration and maximum urinary flow-rate in diagnosing bladder outlet obstruction of patients with benign prostate hyperplasia

目的比较尿流加速度（UFA）和最大尿流率（Qmax）诊断膀胱出口梗阻（B00）的价值。方法分别选取50例前列腺增生（BPH）患者和50例健康者进行前列腺体积、UFA和Qmax测定。以P—Q图梗阻区作为参考标准，比较uFA和Qmax诊断BOO的灵敏度和特异性。结果BPH组UFA明显低于非BPH组（P〈0．05）。以UFA〈2ml／s。和Qmax〈10ml／s作为诊断B00参考标准，灵敏度和特异度分别为88％、75％与81％、63％，与参考标准P—Q图提示梗阻一致性分析Kappa值分别为0．55比0．35。结论UFA可以作为诊断BPH患者B00的依据之一。

Objective To assess the value of the urine flow acceleration（UFA）versus maximum urinary flow-rate （Qmax） for diagnosis of bladder outlet obstruction （BOO） in benign prostate hyperplasia （BPH）. Methods A total of 50 men with BPH and 50 normal men were included in this study. Urodynamic examinations were performed in all patients according to the recommendations of the International Continence Society. Prostate volume, UFA and Qmax of each patient were analyzed and the results were compared between two groups. Results The UFA and Qmax of BPH group were much lower than that of the control group ^（2.05^0.85）ml/s2 vs. （4.60q-1.25）ml/s2 ~ （8.50＋ 1.05）ml/s vs. （ 13.00 4- 3.35） ml/s, P ~ 0.05]. The prostate volume in BPH group was increased compared with control group [（28.64-9.8） ml vs. （24.24-7.6）ml, P%0.05]. As diagnosis standard of UFA%2.05 ml/s2 and Qmax%10 ml/s, the sensitivity and specificity of UFA and Qmax in diagnosing BOO were （88 G, 75 G ）vs. （81 ~, 63 G ）. While compared with the result of P-Q chart, the Kappa values in correspondence analysis were 0.55 vs. O. 35. The sensitivity, specificity and Kappa value of UFA in diagnosing BOO in BPHs were slightly higher than that of Qmax in comparison with the gold standard （BOO diagnosed by P-Q figure）. Conclusions The UFA is a useful urodynamics parameter in diagnosing BOO of BPH.