摘要
目的探讨盆底超声诊断压力性尿失禁（SUI）的超声指标、诊断标准及诊断价值。方法应用单因素logistic回归比较260例SUI患者与60例正常女性盆底超声参数的差异，寻找其相关诊断指标，采用ROC曲线评估其诊断标准及诊断价值。结果两组患者静息状态时尿道倾斜角、肛提肌裂孔面积以及Valsalva动作时膀胱颈位置、膀胱位置、尿道倾斜角、膀胱尿道后角、肛提肌裂孔面积、膀胱颈移动度及尿道旋转角比较差异均有统计学意义（均P〈0．05）；两组患者年龄、体质指数、静息状态时膀胱颈位置、膀胱位置、膀胱尿道后角比较差异均无统计学意义（均P〉0．05）。应用ROC曲线分析得出静息尿道倾斜角、肛提肌裂孔面积、Valsalva动作时膀胱颈位置、膀胱位置、尿道倾斜角、膀胱尿道后角、肛提肌裂孔面积、膀胱颈移动度、尿道旋转角诊断SUI的截断值分别为16．5°、13．5cm2、3．5mm、0．5mm、29．5°、139．5°、19．5cm°、24．5mm、45．5°，敏感度／特异度分别为54．6％／66．7％、49．2％／80．0％、68．1％／95．0％、64．2％／9s．300、67．3％／93．3％、73．5％／50．0％、68．8％／81．7％、70．0％／95．0％、67．2％／85．0％，ROC曲线下面积分别为0．625、0．668、0．855、0．854、0．817、0．622、0．811、0．866、0．817。结论盆底超声是诊断SUI较好的方法，超声诊断指标、诊断标准及诊断价值的提出为超声诊断SUI提供了客观依据。
Objective To investigate the diagnostic parameters, criteria and diagnostic value of pelvic floor ultrasound in female stress urinary incontinence（SUI）. Methods Simple factor logistic regression analysis was used to compare the difference of ultrasonic parameters between SUI patients（260 cases） and asymptomatic subjects（60 cases） to find the relevant diagnostic indexes, and to evaluate the diagnostic criteria and diagnostic value by the ROC curve. Results There were significant differences in urethral inclination angle and levator hiatus area in resting and bladder neck position, bladder position, urethral inclination angle, retrovesical angle, levator hiatus area in Valsalva state and urethral rotation angle, bladder neck mobility between the two groups （all P 〈 0.05）. There was no significant difference in age, BMI, bladder neck position, bladder position, retrovesical angle between resting in the two groups （all P 〈0.05）. Using the ROC curve analysis, the cut-off points of urethral inclination angle and levator hiatus area in resting, bladder neck and bladder position, urethral inclination angle, retrovesical angle, levator hiatus area in Valsalva, bladder neck mobility and urethra rotation angle to diagnose SUI were 16.5°, 13.5 cm2, 3.5 mm, 0.5 mm, 29.5°, 139.5°, 19.5 cm2, 24.5 mm, 45.5°, respectively. The sensitivity/specificity were 54.6%/66.7%, 49.2%/80.0%, 68.1%/95.0%, 64.2%/98.3%, 67.3%/93.3%, 73.5%/50.0%, 68.8%/81.7%,70.0%/95.0%, 67.2%/85.0%, respectively. The area under the curve were 0.625, 0.668,0.855,0.854,0.817,0.622,0.811,0.866,0.817,respectively. Conclusions Pelvic floor ultrasound is a better way to diagnose stress urinary incontinence, and it provides an objective basis for the diagnosis of SUI.
出处
《中华超声影像学杂志》
CSCD
北大核心
2017年第7期618-622,共5页
Chinese Journal of Ultrasonography
基金
广东省科技计划项目（2014A020212661）
广东省医学科研基金（A2015284）
关键词
超声检查
骨盆底
尿失禁
压力性
Ultrasonography
Pelvic floor
Urinary incontinence, stress
