前列腺突入膀胱长度与下尿路症状关系的单中心分析

Intravesical prostatic protrusion correlates with Qmax and voiding symptoms in Chinese men with lower urinary tract symptoms

目的探讨门诊新诊断良性前列腺增生(benign prostatic hyperplasia,BPH)患者中前列腺突入膀胱长度(intravesical prostatic protrusion,IPP)与下尿路症状(lower urinary tract symptoms,LUTS)、前列腺体积(prostatic volume,PV)及最大尿流率(Qmax)的关系。方法纳入2012年1月至2014年1月因LUTS于本院门诊诊治的650例男性患者的临床资料,采用国际前列腺症状评分(international prostate symptom score,IPSS)评估患者LUTS的严重程度,采用经直肠超声测量患者的PV和IPP,采用尿流率仪测定Qmax。统计分析IPP与LUTS及其他指标间的关系。结果 650例入组患者平均年龄(67.7±8.1)岁,平均PV(45.9±21.1)ml,平均Qmax(12.8±6.1)ml/s,平均IPP(5.4±6.6)mm。IPSS总分为(15.5±7.0)分,其中刺激症状评分为(6.6±3.2)分,梗阻症状评分为(6.6±4.0)分,夜尿次数评分为(2.9±1.4)分。相关分析表明,IPP与PV(β=0.13,P<0.001)、IPSS梗阻症状评分(β=0.44,P=0.003)呈明显正相关关系,与Qmax(β=–0.31,P<0.001)呈明显负相关关系。结论在伴有LUTS的男性患者中,IPP与Qmax和梗阻症状明显相关。采用经直肠超声测量IPP可判断患者是否存在膀胱出口梗阻或严重的排尿症状,有助于制定后续治疗方案。

Objective To explore the relationship between intravesical prostatic protrusion （IPP） and many clinical factors such as lower urinary tract symptoms （LUTS）, prostatic volume （PV） or maximal flow rate （Qmax） among the patients with benign prostate hyperplasia （BPH）. Method This study included 650 men （aged more than 40 years） with LUTS who visited the clinic between January 2012 and January 2014. IPSS was used to evaluate the severity of LUTS. PV and IPP were assessed by transrectal ultrasound. Result A total of 650 men with LUTS were evaluated and entered into the study. The mean age of the patients was （67.6± 8.1） years. The mean PV was （45.9± 21.1） ml. The mean IPSS total score, irritative subscore, obstructive subscore, and nocturia subscore were 15.5 ±7.0, 6.6± 3.2, 6.6 ±4.0, and 2.9± 1.4, respectively. The mean Qmax was （12.8±6.1） ml/s, and the mean IPP was （5.4±6.6） mm. Correlation analysis indicated that PV （β= 0.13, P〈0.001）, Qmax （β= -0.31, P〈0.001）, and IPSS obstructive subscore （β=0.44, P=0.003） varied with IPP. Conclusion This study showed that the IPP was associated with Qmax and voiding symptoms in men with LUTS. Measuring IPP when performing TRUS indicates whether patients have BOO or serious voiding symptoms, and hence has great significance in treatment.