Correlation between overactive bladder and bladder outlet obstruction in benign prostatic hyperplasia
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摘要: 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 （1 cmH2O=0.098 kPa，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。Abstract: Objective: To analyze the relationship between overactive bladder(OAB) and bladder outlet obstruction(BOO) in patients with benign prostatic hyperplasia(BPH). Method: Total of 163 patients with BPH were divided into 4 severity degrees according to overactive bladder symptom score(OABSS), such as Grade 0(no urgent urination); Grade 1(OABSS ≤ 5); Grade 2(6-11); Grade 3(OABSS ≥ 12). Prostate three diameters and the intravesical prostatic protrusion(IPP) was measured by transabdominal ultrasound. Urodynamic examination included maximum flow rate(Qmax),Pdet@Qmax, residual urine volume(RUV) and AG value. For statistical analysis AVOVA(analysis of variance) and Spearman correlation were used.Result: In the 163 cases, the OABSS degrees were as follows:Grade 0,44 cases;Grade 1,35 cases;Grade 2,46 cases and Grade 3,38 cases. There were no statistical significances in age,prostatic volume and Qmax. As the degree of OABSS increased, IPSS increased (Grade 0 to 3:8.4±4.2, 12.7±3.8, 15.6±3.6, 18.5±4.1, respectively; F=49.931, P=0.000); IPP increased (Grade 0 to 3:0.4±0.3, 0.8±0.5, 1.1±0.7, 1.3±0.6 cm, respectively; F=21.385, P=0.000); RUV increased (Grade 0 to 3:50.6±36.1, 64.5±29.0, 68.3±30.8, 72.7±39.2 ml, respectively; F=3.345, P=0.021); Pdet@Qmax increased (Grade 0 to 3:48.3±37.5, 53.6±27.9, 58.7±29.1, 70.4±26.8 cmH2O, respectively; F=3.722,P=0.012). It was also found that the OAB symptom was significantly correlated with AG value, bladder outlet obstruction (AG>40) incidence increased (Grade 0 to 3:36.4%, 54.3%, 58.7%, 73.7%; r=0.263, P=0.001). Conclusion: There is a significant correlation between the OAB symptom and BOO in patients with BPH.
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