良性前列腺增生电切术后膀胱过度活动症的风险预测模型

doi:10.19558/j.cnki.10-1020/r.2022.04.010

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摘要 目的：建立良性前列腺增生（BPH）电切术后膀胱过度活动综合症（OAB）的列线图模型。方法：回顾分析2018年6月至2021年9月在我院行经尿道前列腺电切术的BPH患者124例,根据术后是否出现OAB分为OAB组23例和非OAB组101例。单因素及多因素Logistic回归分析BPH患者电切术后OAB的独立预测因素。R4.1.3软件构建列线图模型。结果：124例患者中23例术后出现OAB,发生率为18.55%。多因素Logistic回归分析结果显示前列腺体积、残余尿量、最大尿流率、IPSS评分、逼尿肌压力为BPH电切术后OAB发生的独立危险因素（P<0.05）。BPH电切术后OAB发生风险预测模型为：Y=0.072×前列腺体积+0.043×残余尿量-0.092×最大尿流率+0.131×IPSS评分-0.082×逼尿肌压力。采用R4.1.3软件构建列线图模型,Bootstrap法内部验证结果显示平均绝对误差为0.021,预测曲线与标准曲线基本拟合,提示模型预测准确度较高。ROC曲线下面积为0.929,95%CI为0.858~0.999,提示模型预测特异度高。结论：BPH电切术后OAB发生率较高,主要受前列腺体积、残余尿量、最大尿流率等因素影响,以上述因素构建的列线图模型具有较高的预测准确度。

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	曾秀育
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关键词 ：前列腺增生, 膀胱, 逼尿过度, 预测

Abstract：Objective： To establish a nomogram model of over active bladder （OAB） after resection of benign prostatic hyperplasia （BPH）. Methods： 124 patients with BPH who underwent transurethral resection of prostate in our hospital from June 2018 to September 2021 were retrospectively analyzed. They were divided into OAB group （n=23） and non-OAB group （n=101） according to whether OAB occurred after operation. Univariate and multivariate logistic regression were used to analyze the independent predictors of OAB in patients with BPH. R4.1.3 Software builds nomogram model. Results： OAB occurred in 23 of 124 patients, with an incidence rate of 18.55%. Multivariate logistic regression analysis showed that prostate volume, residual urine volume, maximum urinary flow rate, IPSS score and detrusor pressure were independent risk factors for OAB after BPH resection （P<0.05）. The risk prediction model for OAB after BPH resection was： Y=0.072 × prostate volume +0.043 × residual urine volume –0.092 × maximum urinary flow rate+ 0.131 × IPSS score –0.082 × detrusor pressure. The nomogram model is constructed by R4.1.3 software. The internal verification results of Bootstrap method showed that the average absolute error was 0.021, and the prediction curve was basically fitted with the standard curve, which indicated that the prediction accuracy of the model is high. The area under the ROC curve was 0.929, and the 95% CI was 0.858 to 0.999, indicating a high predictive specificity of the model. Conclusion： The incidence of OAB after BPH resection is high, which is mainly affected by prostate volume, residual urine volume, maximum urine flow rate and other factors. The nomogram model constructed by these factors has high prediction accuracy.

Key words： prostatic hyperplasia urinary bladder overactive forecasting

收稿日期: 2022-03-30

通讯作者: 唐黎明, tangniewen68@163.com

引用本文:

曾秀育, 唐黎明, 贺修君. 良性前列腺增生电切术后膀胱过度活动症的风险预测模型[J]. 微创泌尿外科杂志, 2022, 11(4): 263-267.
Zeng Xiuyu, Tang Liming, He Xiujun. Establishment of a risk prediction model for overactive bladder syndrome after resection of benign prostatic hyperplasia. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(4): 263-267.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1788.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2022/V11/I4/263

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