前列腺增生伴逼尿肌活动低下的危险因素分析

An Analysis of the Risk Factors for Predicting Detrusor Underactivityin Patients with Benign Prostatic Hyperplasia

目的探讨良性前列腺增生(BPH)患者合并逼尿肌活动低下(DU)的独立危险因素。方法回顾性分析2014年1月至2022年5月因下尿路症状(LUTS)于我院行尿动力学检查的患者444例。根据患者尿动力学检查结果中的膀胱收缩指数(BCI),将患者分为DU组(BCI<100,n=150)和非DU组(BCI≥100,n=294)。将单因素Logistic回归分析筛选的与DU相关的变量纳入多因素Logistic回归分析,得出BPH患者合并DU的独立危险因素(P<0.05),并绘制受试者工作特征(ROC)曲线评估相关变量的预测价值。结果多因Logistic回归分析提示高龄、较低的尿不尽症状评分、较低的尿急症状评分、较小的前列腺体积(PV)和较低的最大尿流率(Qmax)为BPH患者合并DU的独立危险因素(P<0.05)。由这5个变量组成的DU预测模型的ROC曲线下面积为0.77(AUC=0.77),灵敏度和特异性分别为0.76和0.65。结论高龄、较低的尿不尽症状评分、较低的尿急症状评分、较小的PV和较低的Qmax为BPH患者合并DU的独立危险因素。

Objective To investigate the risk factors for predicting detrusor underactivity(DU)in patients with benign prostatic hyperplasia(BPH).Methods We retrospectively analyzed 444 BPH patients who underwent urodynamic examination in our hospital from January,2014 to May,2022.The bladder contractility index(BCI)was evaluated by urodynamic examination.And patients were divided into two groups:the DU group(BCI<100,n=150)and the non-DU group(BCI≥100,n=294).DU related variables selected by univariate logistic regression analysis were included in multivariate logistic regression analysis to obtain the independent risk factors for DU in BPH patients(P<0.05),and receiver operating characteristic(ROC)curve were drawn to evaluate the predictive value of related risk variables.Results Logistic regression analysis showed that older age,a lower incomplete emptying symptom score,a lower urgency symptom score,smaller prostate volume(PV),and a lower maximum flow rate(Qmax)were independent predictors of DU in patients with BPH(P<0.05).The area under the ROC curve of the DU prediction model composed of these five variables was 0.77(AUC=0.77),and the sensitivity and specificity were 0.76 and 0.65,respectively.Conclusion Older age,a lower incomplete emptying symptom score,a lower urgency symptom score,smaller prostate volume,and a lower maximum flow rate are independent predictors of DU in patients with BPH.