氢质子磁共振波谱中胆碱水平对良性前列腺增生合并膀胱过度活动症的诊断价值分析

Diagnostic value analysis of choline levels in hydrogen proton magnetic resonance spectroscopy for benign prostatic hyperplasia combined with overactive bladder

目的探讨氢质子磁共振波谱(^(1)H-MRS)分析中胆碱(Cho)水平对良性前列腺增生患者合并膀胱过度活动症(OAB)的诊断价值。方法选取2022年7月至2023年3月合肥市第二人民医院诊治的60例BPH患者作为研究对象。根据膀胱过度活动症自我评价量表(OABSS)将其分为BPH合并OAB组(n=32)与单纯BPH组(n=28)。采用^(1)H-MRS检测两组膀胱壁中Cho、肌酸(Cr)水平,计算Cho/Cr比值。绘制受试者工作特征(ROC)曲线分析相关指标对BPH合并OAB的诊断效能。结果BPH合并OAB组膀胱壁中Cho、Cho/Cr较单纯BPH组显著升高,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,Cho/Cr、膀胱壁厚度(BWT)是诊断BPH合并OAB的因素。ROC曲线结果显示,Cho/Cr可作为诊断BPH合并OAB的指标,截断值为0.70,Cho/Cr联合BWT诊断的效能更高,灵敏度、特异度分别为84.40%、67.90%,截断值为0.47。结论^(1)H-MRS分析中膀胱壁Cho与BPH合并OAB密切相关,Cho/Cr联合BWT具有良好的诊断价值。

Objective To explore the diagnostic value of choline(Cho)levels in hydrogen proton magnetic resonance spectroscopy(^(1)H-MRS)analysis for benign prostatic hyperplasia(BPH)combined with overactive bladder(OAB).Methods A total of 60 BPH patients admitted to the Second People′s Hospital of Hefei from July 2022 to March 2023 were selected as the study objects.They were divided into the BPH combined OAB group(n=32)and the BPH alone group(n=28)according to the overactive bladder self-evaluation scale(OABSS).Cho and creatine(Cr)levels in the bladder wall of the two groups were detected using^(1)H-MRS,and the Cho/Cr ratio was calculated.The diagnostic efficacy of the relevant indexes for BPH combined with OAB was analyzed by plotting the receiver operating characteristics(ROC)curves.Results Cho and Cho/Cr were significantly increased in the bladder wall in the BPH combined OAB group than the BPH alone group,and the differences were statistically significant(P<0.05).The results of multivariable Logistic regression analysis showed that Cho/Cr and bladder wall thickness(BWT)were the factors for the diagnosis of BPH combined with OAB.The results of the ROC curve showed that Cho/Cr could be used as a diagnostic indicator of BPH combined with OAB,with the optimal cut-off value at 0.70.The diagnostic efficacy of Cho/Cr combined with BWT diagnosis was higher,with the 84.40%sensitivity and 67.90%specificity,and the cut-off value was 0.47.Conclusions The bladder wall Cho in^(1)H-MRS analysis is closely associated with BPH combined with OAB,and Cho/Cr combined with BWT has good diagnostic value.