摘要 为探讨前列腺增生症(BPH)梗阻致膀胱功能改变的临床意义，对59例BPH病人进行全面尿动力学检查。结果：(1)最大逼尿肌等容收缩压(Piso)与逼尿肌收缩速度呈正相关(r=0.7167,P<0.001)。(2)Piso随膀胱充盈量增加而显著下降(P<0.001)。(3)Piso与BPH梗阻程度呈正相关性(r=0.6781,P<0.001)。(4)当剩余尿量≥100ml，逼尿肌储能显著下降(P<0.001)。(5)不稳定膀胱组的Piso显著高于稳定膀胱组。结果认为：不稳定膀胱是引起BPH病人临床症状的主要因素之一，膀胱等容收缩试验应用于BPH病人有重要的临床价值。

An urodynamic study of detrusorfunction in BPH patients with bladder outlet obstruction Zhang Zhenbao^* ,Zhang Shichun,Qi Fan,et al.Department ofUrology,the Second Affiliated Hospital,Medical College of Shantou University,Shantou515031

    Abstract 59 BPH patients with bladder outlet obstruction were evaluated withuroflowmentry,postvoid residual measurement,cystometry,isometric test,urethral closurepressure profilometry and micturitional urethral pressure profilometry (MUPP).Subjectivesymptoms were assessed with international prostatic symptom score (IPSS).The isometrictest was performed by occluding the bladder outlet before the onset of a detrusorcontraction.The results revealed that the maximum isometric contraction pressure (Piso)correlated well with the detrusor contraction velocity (r=0.7167,P<0.001).As the bladder was filled so that the patient experienced astrong desire to void,the value of Piso was significantly decreased (P<0.001).A significant correlation (r=0.6781,P<0.001) was found between Piso and the severity of bladder outletobstrution as determined by the voiding profilometry gradient.When the postvoid residualurine volume was more than or equal to 100ml,the potential of detrusor was significantlydecreased (P<0.001).37(63%) of the 59 presenteddetrusor instability.Patients with detrusor instability tended to have a higher valus ofIPSS,an acceleration of flow rate and a higher Piso than those with stable bladders,butthe bladder capacity and urine volume required to evoke a first desire to void wassignificantly decreased.It was believed that detrusor isometric contraction test is aneffective alternative method of assessing detrusor contractibility by which thepathophysiologic changes in bladder outlet obstruction caused by BPH could be understoodbetter.

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