非增生及大、小体积良性前列腺增生超声参数对比研究

Comparative study of ultrasound parameters of non-hyperplasia and benign prostatic hyperplasia of large volume and small volume

目的研究对比大、小体积良性前列腺增生(BPH)与膀胱出口梗阻相关的超声参数。方法选取到本院行经直肠超声检查患者106例分为3组,非增生组32例,大体积BPH组42例、小体积BPH组32例。应用经直肠应变力弹性成像获取三组前列腺弹性图像,运用统计学方法比较三组前列腺内腺动脉血流阻力指数、弹性评分、内外腺应变比、残余尿量;比较大、小体积BPH组尿流动力学检查AG值,分析两组BPH超声参数与AG值的相关性。结果大体积BPH组残余尿量、内外腺应变比、弹性评分、内腺动脉血流阻力指数均高于非增生组及小体积BPH组(P<0.05),小体积BPH组残余尿量、弹性评分、内腺动脉血流阻力指数均高于非增生组(P<0.05),非增生组与小体积BPH组内外腺应变比差异无统计学意义(P>0.05);大体积BPH组AG值显著高于小体积BPH组(U=195.500,P<0.001);大体积BPH组与小体积BPH组残余尿量(r残余量=0.575,P<0.001)、弹性评分(r弹性评分=0.514,P<0.001)、动脉血流阻力指数(r血流阻力指数=0.390,P<0.05)与AG值均呈正相关关系,内外腺应变比与AG值(r内外应变比=0.217,P>0.05)相关关系不具有统计学意义。结论增生后,前列腺组织硬度增加,前列腺内腺动脉血流阻力指数增高;大体积BPH与小体积BPH相比,其与膀胱出口梗阻相关的超声参数值更大、引起的梗阻程度更重。

Objective To study and compare the ultrasonic parameters(related with bladder outlet obstruction)of large and small volume benign prostatic hyperplasia(BPH).Methods 106 patients underwent transrectal ultrasound examination in our hospital were divided into three groups,with 32 patients in non-hyperplasia group,42 patients in large volume BPH group and 32 patients in small volume BPH group.Prostate elastic images of the three groups were obtained by transrectal strain force elastography.The three groups were compared in the artery resistance index of intraprostatic gland,elasticity score,strain ratio of inner and outer gland,residual urine volume by means of statistical methods.The AG values of urodynamic examination in large and small volume BPH groups were compared,and the correlation between BPH ultrasound parameters and AG values in the two groups was analyzed.Results The residual urine volume,strain ratio of inner and outer gland,elasticity score and artery resistance index of the large volume BPH group were higher than those of the small volume BPH group and the non-hyperplasia group(P<0.05).The residual urine volume,elasticity score and artery resistance index of prostate inner-gland of the small volume BPH group were higher than those of the non-hyperplasia group(P<0.05).There was no statistical significant difference in the strain ratios of inner and outer gland between the small volume BPH group and the non-hyperplasia group(P>0.05).The AG value of the large volume BPH group was significantly higher than that of the small volume BPH group(U=195.500,P<0.001).The residual urine volume(r residual urine volume=0.575,P<0.001),elasticity score(r elasticity score=0.514,P<0.001),artery resistance index(r resistance index=0.390,P<0.05)of the large volume BPH group and the small volume BPH group were positively correlated with their AG values.The correlation between the AG value and the strain ratio of inner and outer gland(r strain ratio of inner and outer gland=0.217,P>0.05)was not statistically significant.Conclusion After hyperplasia,the hardness of prostate tissues and the artery resistance index of intraprostatic gland increase.Compared with small volume BPH,large volume BPH has larger values of ultrasound parameters associated with bladder outlet obstruction and causes more severe obstruction.