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目的分析新型可视前列腺症状评分(VPSS)与国际前列腺症状评分(IPSS)及最大尿流率(Qmax)的相关性,评估VPSS对良性前列腺增生症(BPH)症状严重程度及临床应用的价值。方法门诊选取274位良性前列腺增生症患者进行IPSS和VPSS评分,VPSS包括Q1(尿频)、Q2(夜尿)、Q3(尿线症状)和Q4(生活质量)4个问题,分别统计每个问题的得分及总分,并测量患者最大尿流率(Qmax)和平均尿流率(Qave),运用χ2检验、Spearman相关性分析、LSD多重检验、SNK检验及Mantel-Haenszel检验等进行统计学分析。结果完成VPSS评分用时显著少于IPSS评分(84svs.187s,P<0.001),VPSS总分、Q3、Q4与Qmax之间存在明显的负相关(r=-0.552,P<0.000 1;r=-0.633,P<0.000 1;r=-0.553,P<0.000 1);Q3、Q4与VPSS总分之间存在明显的正相关(r=0.716,P<0.000 1;r=0.799,P<0.000 1)。Q3的分组中,各组间存在显著性差异(P<0.000 1);Qmax≤15mL/s的百分率明显与VPSS Q3得分呈线性递增关系。结论 VPSS与IPSS、Qmax间存在明显相关性,而在良性前列腺增生症患者的下尿路症状评估中,VPSS较IPSS更适合不同教育程度的患者,尤其是受教育程度及读写能力较低的患者。
Objective To analyze the correlation between VPSS and IPSS and Qmax, and evaluate the value of VPSS for the severity of BPH and its clinical application. Methods Outpatients were enrolled in this study. 273 patients with benign prostatic hyperplasia (IPSS) and VPSS were scored. VPSS consisted of four questions of Q1 (pollakiuria), Q2 (nocturia), Q3 (urine symptoms) and Q4 (quality of life) (Qmax) and average flow rate (Qave) were measured and analyzed byχ2 test, Spearman correlation analysis, LSD multiple test, SNK test and Mantel-Haenszel test . Results VPSS score was significantly lower than that of IPSS score (84svs.187s, P <0.001), VPSS score, Q3, Q4 and Qmax were significantly negative correlation (r = -0.552, P <0.0001; r = 0.633, P <0.0001; r = -0.553, P <0.0001). There was a significant positive correlation between Q3 and Q4 and VPSS total score (r = 0.716, P <0.0001; ). There was a significant difference among groups (P <0.000 1) in Q3 group. The percentage of Qmax≤15 mL / s was linearly increasing with VPSS Q3 score. Conclusions There is a significant correlation between VPSS and IPSS and Qmax. In the evaluation of lower urinary tract symptoms in patients with benign prostatic hyperplasia, VPSS is more suitable than IPSS for patients with different educational level, especially lower education level and literacy patient.