预测前列腺阻塞和膀出口功能障碍在男性下泌尿道症状和小到中等的前列腺体积使用非侵入性诊断工具
Jing-Hui Tian1, Tsung-Cheng Hsieh2,3, Hann-Chorng Kuo1
1Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970473, Taiwan.
Biomedicines
|December 30, 2025
概括
使用膀出口功能障碍 (BOD) 的非侵入性临床参数的预测模型显示敏感性和特异性较低. 在考虑侵入性治疗时,对于患有下泌尿道症状 (LUTS) 和小至中度前列腺患者,侵入性泌尿动力学研究仍然是必要的.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗工程 医疗工程
- 临床诊断 临床诊断 临床诊断
背景情况:
- 下尿道症状 (LUTS) 往往表明膀出口功能障碍 (BOD),需要准确的诊断.
- 目前对BOD的诊断方法可能具有侵入性,这促使研究非侵入性预测模型.
- 早期识别和分层 BOD 对于有效的患者管理至关重要.
研究的目的:
- 开发使用非侵入性临床参数的预测模型,用于早期识别和分层疑似膀出口功能障碍 (BOD).
- 为了减少对LUTS患者的侵入性诊断程序的依赖.
- 确定BOD的特定亚型,包括良性前列腺阻塞 (BPO).
主要方法:
- 对307名男性患者进行了回顾性研究,这些患者的LUTS不耐医疗治疗.
- 一种两阶段的建模方法,用于BOD检测和亚型识别的后向阶段逻辑回归.
- 数据集分为培训 (70%) 和测试 (30%) 集,用于模型开发和外部验证;通过五重交叉验证进行内部验证.
主要成果:
- 身体疾病检测模型包括最大流速,空化体积,腹腔前列腺突起 (IPP) 和前列腺尿道角 (PUA).
- BPO模型包括空虚后残留量 (PVR),前列腺总体积 (TPV) 和IPP.
- 两种模型都表现出低的灵敏度和特异性 (BOD模型:0.47特异性;BPO模型:0.58灵敏度),表明对确定诊断的临床实用性有限.
结论:
- 仅通过非侵入性临床参数,就能提供有限的准确性 (低灵敏度和特异性) 来识别BPO和其他BOD亚型.
- 侵入性视频泌尿动力学研究对于患有LUTS和前列腺体积小到中等的患者来说仍然是必不可少的,尤其是在考虑侵入性治疗时.
- 开发的模型可以作为初步查工具,但不能取代已有的侵入性诊断方法.
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