摘要
目的探讨尿动力学指标对糖尿病神经源性膀胱(DNB)的诊断价值。方法回顾性分析2018年8月至2020年6月南华大学衡阳医学院附属邵阳医院确诊为DNB的141例患者,按糖尿病病史分为A组(病史≤10年)73例和B组(病史>10年)68例;将同时期的单纯糖尿病患者152例纳入对照组。分别比较三组患者的尿动力学相关指标[膀胱壁厚度(BWT)、初尿意膀胱容量(VS1)及最大尿流率时的逼尿肌压力(PQmax)、最大尿流率(Qmax)、膀胱最大容量(VSD)、膀胱顺应性(BC)等]的差异及其单独与联合的诊断价值。结果B组的BWT值高于A组及对照组,差异均有统计学意义(均P<0.05);B组的VS1值低于A组及对照组,差异均有统计学意义(均P<0.05);A组和B组的PQmax水平均显著低于对照组(均P<0.05),三组的Qmax、BC和VSD水平比较,差异均无统计学意义(均P>0.05)。单因素分析结果显示,PQmax、BWT和VS1均为DNB的独立危险因素(均P<0.05)。通过对PQmax、BWT、VS1的单独与联合诊断效能的受试者工作特征(ROC)曲线分析显示:VS1的曲线下面积(AUC)为0.686,灵敏度与特异度分别为70.14%、69.19%;BWT的AUC为0.823,灵敏度与特异度分别为88.19%、89.32%;PQmax的AUC为0.714,灵敏度与特异度分别为74.18%、72.38%;联合诊断的AUC为0.879,灵敏度与特异度分别90.28%、90.23%。结论PQmax、BWT、VS1对DNB具有较好的诊断效能。
Objective To investigate the diagnostic value of urodynamic indicators in diabetic neurogenic bladder(DNB).Methods Retrospective analysis was performed on 141 patients with DNB diagnosed in our hospital from August 2018 to June 2020.According to the history of diabetes,all patients were divided into group A(73 cases with medical history≤10 years)and group B(68 cases with medical history>10 years).One hundred and fifty-two patients with simple diabetes during the same period were included in the control group.Urodynamic parameters,such as bladder wall thickness(BWT),primary bladder volume(VS1)and detrusor pressure(PQmax),maximum urine flow rate(Qmax),bladder maximum volume(VSD),bladder compliance(BC)were compared between the three groups and their respective and combined diagnostic values were compared.Results The BWT value of group B was higher than that of group A and significantly higher than that of the control group,and the results were statistically significant(all P<0.05).The VS1 value of group B was lower than that of group A and control group,and the differences were statistically significant(P<0.05).The level of PQmax in group A and group B was significantly lower than that in control group(all P<0.05),and there was no statistical significance in the levels of Qmax,BC and VSD in the three groups(all P>0.05).Univariate analysis showed that PQmax,BWT and VS1 were independent risk factors for DNB(all P<0.05).Receiver operating characteristic(ROC)curve analysis of the diagnostic efficacy of PQmax,BWT and VS1 alone and in combination showed that the area under curve(AUC)of VS1 was 0.686,the sensitivity and specificity were 70.14%and 69.19%,respectively.The AUC of BWT was 0.823,the sensitivity and specificity were 88.19%and 89.32%,respectively.The AUC of PQmax was 0.714,and the sensitivity and specificity were 74.18%and 72.38%,respectively.The AUC of combined diagnosis was 0.879,the sensitivity and specificity were 90.28%and 90.23%,respectively.Conclusions PQmax,BWT and VS1 are effective in the diagnosis of DNB.
作者
林玮键
唐琦
肖宁
朱胜
赵华晟
龙永福
Lin Weijian;Tang Qi;Xiao Ning;Zhu Sheng;Zhao Huasheng;Long Yongfu(Department of Urology,Shaoyang Hospital Affiliated to Hengyang Medical School,University of South China,Shaoyang 422000,China;Department of Urology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541000,China)
出处
《国际泌尿系统杂志》
2022年第2期268-272,共5页
International Journal of Urology and Nephrology
基金
湖南省科技创新计划项目(2017SK51404)
南华大学研究生科研创新项目(203YXC034)。
