中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2014年
4期
282-287
,共6页
张明博%付帅%周昀%唐杰
張明博%付帥%週昀%唐傑
장명박%부수%주윤%당걸
前列腺增生%膀胱出口梗阻%弹性模量%剪切波弹性成像%前瞻性研究
前列腺增生%膀胱齣口梗阻%彈性模量%剪切波彈性成像%前瞻性研究
전렬선증생%방광출구경조%탄성모량%전절파탄성성상%전첨성연구
Benign prostatic hyperplasia%Bladder outlet obstruction%Elastic modulus%Shear wave sonoelastography%Prospective studies
目的 评价良性前列腺增生(BPH)患者前列腺组织弹性模量与膀胱出口梗阻(BOO)程度的关系,建立无创评价BOO程度的新指标. 方法 2011年11月至2012年11月,34例BPH患者纳入前瞻性研究.采集患者临床资料,包括年龄、国际前列腺症状评分、生活质量评分;然后应用经直肠超声测定患者的前列腺体积参数,包括前列腺总体积、移行区体积和移行区指数,并采用剪切波超声弹性成像测定患者前列腺组织的弹性模量;超声检查后由泌尿外科医生完成尿动力学检查,根据压力-流率曲线确定是否存在BOO及梗阻程度.分析不同梗阻程度患者前列腺组织弹性模量以及其他参数(包括临床资料、前列腺体积参数和尿动力学参数)的差异,评价梗阻程度与各参数的相关性,计算各参数诊断BOO的ROC曲线,获得无创评价BOO程度的最佳参数,并计算其诊断价值.结果 34例患者中无梗阻、轻-中度梗阻、重度梗阻分别为9、12、13例,弹性模量分别为(27.3±5.0)、(30.7±2.8)、(34.7±2.4) kPa.前列腺组织弹性模量与BOO程度具有良好的相关性(r=0.754,P=0.000),其相关系数高于其他参数.前列腺组织弹性模量诊断BOO的ROC曲线下面积为0.853(95％CI 0.720～0.986),以31.6 kPa为界值,诊断梗阻的敏感性、特异性和准确性分别为72％、90％和81％.结论 前列腺组织弹性模量与BOO程度相关,可以为BPH患者提供无创评价BOO程度的新指标.
目的 評價良性前列腺增生(BPH)患者前列腺組織彈性模量與膀胱齣口梗阻(BOO)程度的關繫,建立無創評價BOO程度的新指標. 方法 2011年11月至2012年11月,34例BPH患者納入前瞻性研究.採集患者臨床資料,包括年齡、國際前列腺癥狀評分、生活質量評分;然後應用經直腸超聲測定患者的前列腺體積參數,包括前列腺總體積、移行區體積和移行區指數,併採用剪切波超聲彈性成像測定患者前列腺組織的彈性模量;超聲檢查後由泌尿外科醫生完成尿動力學檢查,根據壓力-流率麯線確定是否存在BOO及梗阻程度.分析不同梗阻程度患者前列腺組織彈性模量以及其他參數(包括臨床資料、前列腺體積參數和尿動力學參數)的差異,評價梗阻程度與各參數的相關性,計算各參數診斷BOO的ROC麯線,穫得無創評價BOO程度的最佳參數,併計算其診斷價值.結果 34例患者中無梗阻、輕-中度梗阻、重度梗阻分彆為9、12、13例,彈性模量分彆為(27.3±5.0)、(30.7±2.8)、(34.7±2.4) kPa.前列腺組織彈性模量與BOO程度具有良好的相關性(r=0.754,P=0.000),其相關繫數高于其他參數.前列腺組織彈性模量診斷BOO的ROC麯線下麵積為0.853(95％CI 0.720～0.986),以31.6 kPa為界值,診斷梗阻的敏感性、特異性和準確性分彆為72％、90％和81％.結論 前列腺組織彈性模量與BOO程度相關,可以為BPH患者提供無創評價BOO程度的新指標.
목적 평개량성전렬선증생(BPH)환자전렬선조직탄성모량여방광출구경조(BOO)정도적관계,건립무창평개BOO정도적신지표. 방법 2011년11월지2012년11월,34례BPH환자납입전첨성연구.채집환자림상자료,포괄년령、국제전렬선증상평분、생활질량평분;연후응용경직장초성측정환자적전렬선체적삼수,포괄전렬선총체적、이행구체적화이행구지수,병채용전절파초성탄성성상측정환자전렬선조직적탄성모량;초성검사후유비뇨외과의생완성뇨동역학검사,근거압력-류솔곡선학정시부존재BOO급경조정도.분석불동경조정도환자전렬선조직탄성모량이급기타삼수(포괄림상자료、전렬선체적삼수화뇨동역학삼수)적차이,평개경조정도여각삼수적상관성,계산각삼수진단BOO적ROC곡선,획득무창평개BOO정도적최가삼수,병계산기진단개치.결과 34례환자중무경조、경-중도경조、중도경조분별위9、12、13례,탄성모량분별위(27.3±5.0)、(30.7±2.8)、(34.7±2.4) kPa.전렬선조직탄성모량여BOO정도구유량호적상관성(r=0.754,P=0.000),기상관계수고우기타삼수.전렬선조직탄성모량진단BOO적ROC곡선하면적위0.853(95％CI 0.720～0.986),이31.6 kPa위계치,진단경조적민감성、특이성화준학성분별위72％、90％화81％.결론 전렬선조직탄성모량여BOO정도상관,가이위BPH환자제공무창평개BOO정도적신지표.
Objective To evaluate the correlation between the elastic modulus of prostate and the degree of bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH) patients in order to build a new non-invasive diagnostic indicator for BOO.Methods From november 2011 to November 2012,a total of 34 BPH patients were enrolled in this prospective study.Clinical information of the patients including age,international prostate symptom score (IPSS) and quality of life (QOL) were collected.The morphological features of prostate including total prostate volume,transitaion zone volume and transition zone index were detected by transrectal ultrasound (US),and prostate elastic modulus was detected using shear wave sonoelastograhy.After US examination,urodynamic study was performed by the urologist and pressure-flow curves were used to determine the diagnosis and the degree of bladder outlet obstruction.The correlation of prostate elastic modulus and other features including clinical information,morphological features and urodynamic features with the degree of bladder outlet obstruction were evaluated.ROC curves were evaluated.The feature with the best diagnostic performance was obtained,the diagnostic values of which were calculated.Results 9 patients had no BOO,with the average prostate elastic modulus of (27.3±5.0) kPa; 12 patients had mild to moderate BOO,with the average prostate elastic modulus of (30.7±2.8) kPa; 13 patients had severe BOO,with the average prostate elastic modulus of (34.7±2.4) kPa.The prostate elastic modulus had higher correlation coefficient with the degree of bladder outlet obstruction than the other features (r =0.754,P=0.000).It also had the highest AUC of 0.853 (95％CI 0.720-0.986).At a cutoffof 31.65 kPa,the sensitivity,specificity and accuracy of the prostate elastic modulus for the diagnosis of BOO were 72％,90％and 81％ respectively.Conclusion The prostate elastic modulus is highly correlated with the degree of bladder outlet obstruction,which might serve as a novel,promising indicator to evaluate BOO in BPH patients.
