无创检测方法预测中国良性前列腺增生患者急性尿潴留风险

A noninvasive method for predicting the risk of acute urinary retention among benign prostatic hyperplasia patients in China

目的建立预测良性前列腺增生(BPH)患者急性尿潴留风险的预测模型病人。方法通过我院的数据库收集2011年3月至2012年12月于我院就诊、诊断为BPH并建立随访的患者,共225例,其中42例患者在随访期间有急性尿潴留的病史。所有患者均进行国际前列腺症状评分(IPSS),生活质量评分(QoL)和血清前列腺特异性抗原(PSA)的测定,并且经直肠前列腺超声(TRUS)测得前列腺体积(PV),移行区体积(TZV),移行区比值(TZI)及膀胱内前列腺突出(IPP)的评估。根据患者有无急性尿潴留将患者分为两组:尿潴留组与非尿潴留组,观察两组患者各项指标的差别,并建立预测BPH患者急性尿潴留的风险模型。结果除了年龄以及排尿期评分,尿潴留组患者的所有指标均显著高于非尿潴留组。急性尿潴留风险预测模型:0.558×PSA+0.737×PV,受试者工作曲线下面积0.885,当阈值设定为62.8时,敏感度81%,特异度84.4%。结论急性尿潴留风险预测模型运用方便,可以较为准确地预测BPH患者急性尿潴留的风险,为临床决策提供帮助。

Objective To establish a noninvasive parameter-based score model for predicting the risk of acute urinary retention(AUR) among benign prostatic hyperplasia(BPH) patients. Methods Clinical data of 225 BPH patients who visited our department for lower urinary tract symptom(LUTS) were collected from the database during Mar 2011 and Dec 2012. Of then, 42 patients had the experience of AUR during the follow up. All the patients were evaluated with the International Prostate Symptom Score(IPSS) and Quality of Life(QoL) score, serum prostatic specific antigen(PSA)level, total prostate volume(TPV), transitional zone volume(TZV), transitional zone index(TZI) and Intravesical prostatic protrusion(IPP). The baseline values were used to evaluate the association between two groups with and without the experience of AUR, and a score model for predicting the risk of AUR was established. Results All the parameters in group with AUR except age and voiding score were significantly higher than those in group without AUR. The AUR predicting score(APS) was calculated as: APS=0.558×PSA+0.737×TPV. The sensitivity was 81.0% and the specificity was 84.4%, respectively. The area under curve was 0.885 and the cutoff point was 62.80. Conclusion The established APS could be used conveniently in outpatient department for predicting the risk of AUR among patients associated with BPH in China.