良性前列腺增生合并膀胱出口梗阻非侵入性诊断方法的研究进展

Research progress on noninvasive diagnostic methods of benign prostatic hyperplasia and bladder outlet obstruction

目的：探讨良性前列腺增生（ BPH）合并膀胱出口梗阻（ BOO）的非侵入性诊断方法的研究进展。方法在Pubmed、EMBASE、万方数据库，以“良性前列腺增生”、“膀胱出口梗阻”、“非侵入性诊断方法”为关键词，检索2008年1月—2014年1月有关BPH合并BOO的非侵入性诊断方法的相关文献，结合国内外最新的研究进展，进行归纳总结。结果压力－流率测定是诊断膀胱出口梗阻的金标准，但此方法具有侵入性，而且价格昂贵、过程复杂。近年来，临床上使用的非侵入性诊断BPH合并BOO的方法有无尿动力学测量方法和非侵入性的尿动力学方法。无尿动力学测量方法包括国际前列腺症状评分、残余尿量、前列腺特异性抗原、超声测量等，非侵入性的尿动力学方法包括最大尿流率、阴茎袖套试验、近红外光谱、多普勒阻力指数测定等。这两种非侵入性诊断方法具有无创、简单、重复性好等优点。结论新的非侵入性诊断BPH合并BOO的方法较传统的压力－尿流动力学检测有着无创、简单、重复性好等优点，但尚未有充分证据证明能够取代压力－尿流动力学方法，成为新的诊断BPH合并BOO的金标准，其临床应用价值还需要进一步的研究验证。

Objective To review the research progress on noninvasive diagnostic methods of bladder outlet obstruction （BOO） due to benign prostatic hyperplasia （BPH）. Methods To retrieve the related literatures about the progress in noninvasive diagnostic methods of BOO due to BPH in the PubMed, EMBASE and Wangfang databases by the key words of “BPH”, “BOO” and “noninvasive diagnostic method” from January 2008 to January 2014, and summarize the recent progress at home and abroad. Results The pressure-flow study is the gold standard to diagnose BOO, but it′s invasive, expensive and complicated. In recent years, noninvasive diagnostic methods of BOO due to BPH appear in clinical context, namely the non-urodynamic measurements and noninvasive urodynamic measurements. The non-urodynamic measurements include international prostate symptom score, residual urine volume, prostate specific antigen, ultrasonic measurements and the noninvasive urodynamic measurements include maximal urinary flow rate, penile cuff test, near infrared spectroscopy, doppler resistance index. New noninvasive diagnostic methods have the advantages of being noninvasive, simple and good repeatability. Conclusions Compared with the traditional pressure-flow study, new noninvasive diagnostic methods of BOO due to BPH have noninvasive, simple and well repeatable characteristics, but there are still no sufficient evidences to prove that they can take the place of the pressure-flow study as the gold standard to diagnose BOO due to BPH. The application value of noninvasive diagnostic methods of BOO due to BPH in clinical needs more clinical trials.