前列腺前叶厚度与良性前列腺增生临床进展的相关性研究

Impact of anterior lobe thickness of the prostate on the clinical progression of benign prostatic hyperplasia

目的:探讨前列腺前叶厚度(ALTP)与膀胱出口梗阻(BOO)的相关性,评价ALTP对良性前列腺增生(BPH)临床进展的影响。方法:回顾分析159例BPH患者的ALTP、前列腺体积(PV)、残余尿(PVR)、最大尿流率(Qmax)、BOOI、国际前列腺症状评分(IPSS)等临床指标。分析ALTP与不同程度IPSS、PV、Qmax、年龄、PVR等指标的相关性;评估ALTP与BOO的相关性,绘制ROC曲线,制定前叶厚度分界点,以分界点将前叶厚度分为大、小前叶组,比较两组各临床指标的差异性,评价ALTP与BPH临床进展的相关性。结果:IPSS严重程度与ALTP相关性无统计学差异(P>0.05);ALTP与对应的PV、Qmax相关性无统计学差异(P>0.05);以ALTP为检验变量,BOOI≥40为状态变量绘制ROC曲线,得到ALTP分界点为0.65 cm。大前叶组(ALTP≥0.65 cm)的PV、Qmax、IPSS程度、手术率均与小前叶组(ALTP<0.65 cm)相比有显著差异(P<0.05)。结论:ALTP厚薄不一,与PV大小不成比例;IPSS严重程度与ALTP不成比例;当ALTP≥0.65 cm时增加了BOO发生率,可能是BPH临床进展的危险因素。

Objective:To investigate the correlation of the anterior lobe thickness of the prostate(ALTP)with bladder outlet obstruction(BOO),and evaluate the effect of ALTP on the clinical progression of BPH.Methods:This retrospective study included 159 cases of BPH.We obtained the clinical indicators of the patients,including ALTP,prostate volume(PV),postvoid residual urine(PVR),maximum urinary flow rate(Qmax),BOO index(BOOI)and IPSS,and analyzed the correlations of ALTP with IPSS,PV,Qmax,age,PVR and BOOI.Using the ROC curve and cut-off point of ALTP,we compared the clinical indicators between the small and large ALTP groups,and analyzed the correlation between ALTP and the clinical progression of BPH.Results:IPSS was not significantly correlated with ALTP(P>0.05),nor was ALTP with PV and Qmax(P>0.05).The area under the ROC curve was 0.742(95%CI:0.656-0.828)and the cut-off point of ALTP was 0.65 cm.Statistically significant differences were observed in PV,Qmax,IPSS and the rate of surgery between the small ALTP(<0.65 cm)and large ALTP(≥0.65 cm)groups(P<0.05).Conclusion:ALTP is not proportional to PV or to IPSS.ALTP≥0.65 cm increases the incidence of BOO,and may be a risk factor for the clinical progression of BPH.