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目的:研究分析BPH患者并发膀胱过度活动症(OAB)与膀胱出口梗阻(BOO)程度的相关性。方法:163例BPH患者,根据OAB症状评分(OABSS)将患者进行严重程度分级:0级无尿急等OAB症状;OABSS为1级≤5分;2级6～11分;3级≥12分。经腹超声测定前列腺三径和前列腺突入膀胱的距离(IPP),尿动力学检查测定最大尿流率(Qmax)、剩余尿,最大尿流率时的逼尿肌压力(P&det@Qmax),并计算出AG值,进行方差分析和相关性分析检验。结果:按OAB症状严重程度分为四组:0级44例,1级35例,2级46例,3级38例。OAB症状程度轻重与患者年龄、前列腺体积、最大自由尿流率等无相关。IPSS评分随OAB症状加重而增高,0～3级分别为(8.4±4.2)、(12.7±3.8)、(15.6±3.6)、(18.5±4.1)分(F=49.931,P=0.000);前列腺中叶增生程度(IPP)呈现显著性升高趋势,0～3级分别为(0.4±0.3)、(0.8±0.5)、(1.1±0.7)、(1.3±0.6)cm(F=21.385,P=0.000);剩余尿量显著增多,0～3级分别为(50.6±36.1)、(64.5±29.0)、(68.3±30.8)、(72.7±39.2)ml(F=3.345,P=0.021);Pdet@Qmax显著增高,0～3级分别为(48.3土37.5)、(53.6±27.9)、(58.7±29.1)、(70.4±26.8)cmH2O(1cmH2O=0.098kPa,F=3.722,P=0.012)。BOO(AG>40)发生率分别为:0级36.4%(16/44)、1级54.3%(19/35)、2级58.7%(27/46)、3级73.7%(28/38),显示OAB症状与AG值呈正相关(r=0.263,P=0.001)。结论:BPH患者并发膀胱过度活动症与膀胱出口梗阻存在显著相关性。
OBJECTIVE: To study the correlation between overactive bladder (OAB) and bladder outlet obstruction (BOO) in patients with BPH. Methods: One hundred and sixty-three BPH patients were classified according to the OAB Symptom Score (OABSS). The severity of OAB symptom was grade 0 without urgency. OABSS was grade 1 ≤ 5, grade 2 6-11, grade 3 ≥ 12 . Transcutaneous sonography was used to determine the IPP of the prostate and the prostatic into the bladder. The maximum urinary flow rate (Qmax), remaining urine, and maximum detrusor pressure (P & det @ Qmax) at the time of urinary flow were determined by urodynamic examination. The AG value was calculated and analyzed by ANOVA and correlation analysis. Results: According to the severity of OAB symptoms, the patients were divided into four groups: 0 in 44 cases, 1 in 35 cases, 2 in 46 cases and 3 in 38 cases. OAB severity and severity of the patient’s age, prostate volume, the largest free urinary flow rate was not related. The score of IPSS increased with the increase of OAB symptoms. The grade of 0 to 3 were (8.4 ± 4.2), (12.7 ± 3.8), (15.6 ± 3.6) and (18.5 ± 4.1) respectively (F = 49.931, P = 0.000) (IPP) showed a trend of significant increase in the middle stage (0 ± 3), (0.8 ± 0.5), (1.1 ± 0.7) and (1.3 ± 0.6) cm respectively 0.000), and the residual urine volume increased significantly (P = 0.45, P = 0.45, P = 0.45, P <0.01) @Qmax was significantly higher in the 0-3level (48.3 ± 37.5), (53.6 ± 27.9 ±), (58.7 ± 29.1) and (70.4 ± 26.8) cmH2O respectively (1cmH2O = 0.098kPa, F = 3.722, P = 0.012). The incidences of BOO (AG> 40) were 0 grade 36.4% (16/44), grade 1 54.3% (19/35), grade 2 58.7% (27/46) and grade 3 73.7% (28/38) , Showing a positive correlation between OAB symptoms and AG values (r = 0.263, P = 0.001). Conclusion: There is a significant correlation between overactive bladder and bladder outlet obstruction in patients with BPH.