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目的:研究逼尿肌过度活动(DO)对BPH患者膀胱排空能力的影响,探讨该影响的原因及意义。方法:选取70例BPH病例,按尿流动力学结果有无DO分为两组,运用统计学方法进行回顾性研究。结果:无DO组剩余尿量(PVR)、最大尿流率(Q_(max))分别为194.38(±205.830)ml、5.94(±3.692)ml/min;有DO组分别为96.00(±103.120)ml、8.19(±3.704)ml/min,相比差异均有统计学意义(P<0.05)。两组中并发上尿路积水者共5例,占7.1%,并发上尿路积水者在两组中的分布差异无统计学意义(P>0.05)。两组中已出现逼尿肌收缩功能受损(DU)者15例,占21.4%,有DO者从下尿路症状(LUTS)出现进展至逼尿肌收缩功能受损的病程明显长于无DO者(P<0.05)。结论:BPH患者中有DO者与无DO者相比,剩余尿量少、最大尿流率高。DO的存在并不增大上尿路受损风险。推测DO可能是逼尿肌代偿性增厚以外的另一种代偿机制,它增大膀胱排空能力,还可能通过减少排尿时逼尿肌能量消耗来延缓逼尿肌收缩功能受损的发生。
Objective: To study the effect of detrusor overactivity (DO) on bladder emptying ability in patients with BPH and to explore the reason and significance of the effect. Methods: Seventy cases of BPH were selected and divided into two groups according to the urodynamic results. The clinical data were retrospectively analyzed by using statistical methods. Results: The residual urine volume (PVR) and maximum flow rate (Q max) of DO group were 194.38 (± 205.830) ml and 5.94 ± 3.692 ml / min, respectively, and those in DO group were 96.00 (± 103.120) ml, 8.19 (± 3.704) ml / min, respectively. There was significant difference between the two groups (P <0.05). There were 5 cases (7.1%) of the patients with upper urinary tract hydronephrosis in both groups. There was no significant difference in the distribution of upper urinary tract water between the two groups (P> 0.05). Fifteen patients (21.4%) had detrusor contractile dysfunction (DU) in both groups. The progression from lower urinary tract symptoms (LUTS) to detrusor contractile function was significantly longer in patients with DO than in those without DO (P <0.05). CONCLUSIONS: Among BPH patients, those with or without DO have less residual urine volume and higher maximum urinary flow rate. The presence of DO does not increase the risk of upper urinary tract injury. It is hypothesized that DO may be another compensatory mechanism besides detrusor compensatory thickening, which increases the capacity of bladder emptying and may also delay the detrusor contractile function impairment by reducing the energy expenditure of detrusor during urination occur.