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目的 分析经直肠超声 (TRUS)测定良性前列腺增生相关指标对诊断膀胱出口梗阻的意义。 方法 良性前列腺增生患者 78例。年龄 6 2～ 78岁 ,平均 (71.6± 5 .0 )岁。IPSS 18～ 2 8,平均 2 2 .0± 2 .2。应用TRUS测定前列腺体积的相关指标 ,同时行尿动力学检查并计算AG值。将年龄、前列腺体积、移行带体积、移行带指数 (TZI)、假定圆面积比 (PCAR)、IPSS等参数分别与AG值进行相关性分析。 结果 前列腺体积 (70 .0 2± 6 2 .10 )ml、移行带体积 (36 .33± 39.37)ml、TZI 0 .4 8±0 .15、PCAR 0 .72± 0 .10。最大尿流率 (Qmax) (8.2 5± 4 .2 1)ml/s、最大尿流率时逼尿肌压力(Pdet.Qmax) (83.2 8± 32 .5 6 )cmH2 O(1cmH2 O =0 .0 98kPa)。相关分析提示 ,TZI(r =0 .75 7,P =0 .0 15 )、IPSS(r =0 .6 93,P =0 .0 2 8)、PCAR(r =0 .80 6 ,P =0 .0 0 8)与AG值显著相关。多元回归分析结果显示 :TZI、PCAR为AG的相关因素 (复相关系数r =0 .95 2 ,决定系数r =0 .90 6 ,校正决定系数r =0 .86 9,P =0 .0 0 3) ,两者的标准化偏回归系数分别为 0 .4 4 0 (P =0 .0 18)和 0 .717(P =0 .0 14 ) ,PCAR对AG的影响强度约为TZI的 1.6 3倍。除外TZI的影响后 ,PCAR为ΔAG的独立相关因素(偏相关系数r =0 .883,P =0 .0 0 8)。
Objective To analyze the significance of transrectal ultrasound (TRUS) in the diagnosis of bladder outlet obstruction related to benign prostatic hyperplasia. Methods Benign prostatic hyperplasia in 78 patients. Age 6 2 ~ 78 years old, with an average (71.6 ± 5 .0) years. IPSS 18 ~ 2 8, an average of 2 2 .0 ± 2 .2. TRUS determination of prostate volume related indicators, simultaneous urodynamic examination and calculate the AG value. Age, prostate volume, transition zone volume, transition zone index (TZI), assumed circular area ratio (PCAR), IPSS and other parameters were correlated with the AG value. Results Prostate volume (70.0 ± 6 2 .10) ml, transition zone volume (36.33 ± 39.37) ml, TZI 0.48 ± 0.15, PCAR 0.72 ± 0.10. The maximal flow rate (Qmax) was (8.25 ± 4.21) ml / s and the detrusor pressure (Pdet.Qmax) at the maximum flow rate was (83.2 8 ± 32.56) cmH 2 O (1cmH 2 O = 0 .0 98kPa). The correlation analysis showed that there were significant differences in the scores of TZI (r = 0.75 7, P = 0.015), IPSS (r = 0.93, P = 0.288), PCAR 0 .0 0 8) was significantly correlated with AG value. Multiple regression analysis showed that TZI and PCAR were related factors of AG (r = 0.95 2, r = 0.90 6, r = 0.86 9, P = 0. 0 0 3), the normalized partial regression coefficients of the two are 0 .4 4 0 (P = 0 .0 18) and 0 .717 (P = 0 .0 14) respectively. The impact of PCAR on AG is about 1.6 3 for TZI Times Except for the influence of TZI, PCAR was an independent factor of ΔAG (partial correlation coefficient r = 0.883, P = 0.080).