实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (8): 788-790.doi: 10.3969/j.issn.1003-9198.2022.08.009

• 临床研究 • 上一篇    下一篇

组织弹性成像硬度预测药物治疗老年良性前列腺增生病人夜尿症状的效果

李绍雷, 丁炎, 吴鹏西, 胡强, 阮钧, 王勇   

  1. 214023 江苏省无锡市,南京医科大学附属无锡人民医院超声医学科(李绍雷,丁炎,吴鹏西);泌尿外科(胡强,阮钧,王勇)
  • 收稿日期:2020-12-29 出版日期:2022-08-20 发布日期:2022-08-23
  • 通讯作者: 王勇,Email: 229837859@qq.com
  • 基金资助:
    无锡市卫计委青年项目(Q201809);无锡市医学青年人才(QNRC069)

Evaluation of the effect of alpha-receptor blockers on nocturia in elderly patients with benign prostatic hyperplasia using elastography

LI Shao-lei, DING Yan, WU Peng-xi, HU Qiang, RUAN Jun, WANG Yong   

  1. LI Shao-lei, DING Yan, WU Peng-xi. Department of Medical Ultrasound; HU Qiang, RUAN Jun, WANG Yong. Department of Urology, Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
  • Received:2020-12-29 Online:2022-08-20 Published:2022-08-23

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摘要： 目的 探讨前列腺组织弹性成像硬度预测α受体阻滞剂治疗老年良性前列腺增生(BPH)病人夜尿症状的效果。 方法 收集136例因夜尿增多服用α受体阻滞剂单药治疗的＞60岁的BPH病人的临床资料,包括年龄、BMI、国际前列腺症状评分(IPSS)、IPSS排尿症状评分(IPSSv)、IPSS存储症状评分(IPSSs)、最大尿流率(Qmax);经直肠超声测量总前列腺体积(TPV)、移行区体积(TZV)、残余尿量(residual urine, PVR),通过前列腺移行区组织实时剪切波弹性成像(shear wave sonoelastography, SWE)得到弹性模量(Emean)。采用Logistic回归分析使用药物后夜尿症状改善的影响因素。 结果 136例病人中54例(39.7%)夜尿症状改善。与夜尿未改善的病人相比,夜尿改善组病人的年龄、TPV、TZV、Qmax和弹性模量Emean更小,差异有统计学意义(P＜0.05);2组BMI、IPSS、IPSSv、IPSSs和PVR差异无统计学意义 (P>0.05) 。多因素分析显示,年龄(OR=2.837,95%CI:1.352~5.827)和Emean(OR=4.258,95%CI:2.065~8.710)是BPH病人夜尿改善的独立影响因素。Emean预测老年BPH病人用药后夜尿改善的AUC为0.747(95%CI:0.628～0.852),最佳截断值为38.4 kPa,灵敏度和特异度分别为74.14%、70.68%。 结论 前列腺组织弹性成像硬度可以预测α受体阻滞剂治疗BPH夜尿症状的效果。

关键词: 前列腺增生, 弹性成像, 预测价值, 夜尿症

Abstract: Objective To investigate the evaluation value of prostatic tissue elastography stiffness on the efficacy of α-receptor blockers in the treatment of nocturia in the elderly patients with benign prostatic hyperplasia (BPH). Methods The clinical data of 136 BPH patients aged > 60 years old who were treated with α-receptor blockers for nocturia were prospectively collected, including age, body mass index (BMI), International Meniscus Symptom Score (IPSS), IPSS voiding symptom score (IPSSv), IPSS stored symptom scores (IPSSs), and maximum urinary flow rate (Qmax) obtained by urodynamic examination; Total prostate volume (TPV), transitional zone volume (TZV), residual urine volume (PVR), and real-time shear wave elastography (SWE) of prostate transitional zone tissue were measured by transrectal ultrasound to obtain the elastic modulus (Emean). Logistic regression was used to analyze the factors influencing the improvement of nocturia after administration. Results Of the 136 patients, 54 (39.7%) cases showed improvement of nocturia. Compared with the patients without improvement of nocturia, the patients in the improvement group had smaller age, TPV, TZV, Qmax and Emean, with statistically significant differences (P<0.05); While the levels of BMI, IPSS, IPSSv, IPSSs and PVR showed no significant differences between the two groups (P>0.05). Multivariate Logistic analysis showed that age (OR=2.837,95%CI:1.352-5.827) and Emean (OR=4.258,95%CI:2.065-8.710) were the independent factors for improvement of nocturia in BPH patients. The area under the receiver operating characteristic curve of Emean for predicting the improvement of nocturia after medication in the elderly patients with BPH was 0.747 (95% CI: 0.628-0.852), with an optimal cut-off point of 38.4 kPa, and the sensitivity and specificity was 74.14% and 70.68%, respectively. Conclusions Prostate tissue elastography stiffness can predict the therapeutic effect of α-receptor blockers in the treatment of BPH nocturia.

Key words: prostatic hyperplasia, elastography, predictive value, nocturia

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