缩肛状态下肛提肌应变率用于评价压力性尿失禁患者盆底肌收缩功能的价值

目的 研究缩肛状态下肛提肌应变率评价压力性尿失禁患者盆底肌收缩功能中的价值,从而为临床提供可量化的客观指标.方法 选取77例压力性尿失禁患者作为研究对象,根据Oxford肌力分级标准分为肌力障碍组27例和非肌力障碍组50例;选择30例其他普通妇科疾病且无盆底肌功能障碍患者作为健康对照组.比较3组缩肛状态下的肛提肌应变率;分析缩肛状态下肛提肌应变率与Oxford肌力分级的相关性;并通过绘制受试者工作特征曲线来探索缩肛状态下肛提肌应变率诊断盆底肌收缩功能障碍的最佳临界值.结果 肌力障碍组缩肛状态下肛提肌应变率低于其他两组(P<0.05).Oxford肌力分级与缩肛状态下肛提肌应变率呈正相关(r=0.815,P<0.05).缩肛状态下肛提肌应变率诊断盆底肌收缩功能障碍最佳临界值为10.07%,曲线下面积为0.888(P<0.05),其灵敏度、特异度、阳性预测值及阴性预测值分别为91.8%、78.6%、80.8%、86.3%.结论 缩肛状态下肛提肌应变率对压力性尿失禁患者盆底肌收缩功能障碍的诊断具有一定价值,但仍需进一步研究以证实其对其他类型疾病患者盆底肌功能的诊断效能.

Value of levator ani muscle strain rate during anal sphincter contraction in evla uating peliv c floor muscle contraction in patients with stress urinary incontinence

Objective To explore the value of levator ani muscle strain rate during anal sphincter contraction in evaluating pelvic floor muscle contraction in patients with stress urinary incontinence (SUI),thus to provide a quantifiable and objective index for clinical practice.Methods Seventy-seven patients with SUI were enrolled and divided into muscle strength impairment group (n=27) or muscle strength non-impairment group ( n=50 ) according to Oxford Scale .Thirty patients with other common gynecological diseases but without pelvic floor muscle disorders were enrolled as control group .The levator ani muscle strain rate during anal sphincter contraction were compared among three groups.The correlation between the levator ani muscle strain rate during anal sphincter contraction and the grade of Oxford Scale was analyzed.Receiver operating characteristic curve was used to determine the optimal threshold value of the anal levator ani muscle strain rate during anal sphincter contraction for diagnosing the impairment of pelvic floor muscle contraction.Results The levator ani muscle strain rate during anal sphincter contraction was lower in the muscle strength impairment group compared to the other groups (P<0.05).The grade of Oxford Scale positively correlated with the levator ani muscle strain rate during anal sphincter contraction (r=0.815,P<0.05).The optimal threshold value of levator ani muscle strain rate during anal sphincter contraction for diagnosing the impairment of pelvic floor muscle contraction was 10.07%,and the area under the curve was 0.888(P<0.05).The sensitivity,specificity,positive predictive value,and negative predictive value were 91.8%,78.6%,80.8%,and 86.3%,respectively.Conclusion The levator ani muscle strain rate during anal sphincter contraction obtains a certain value for diagnosing the impairment of pelvic floor muscle contraction in patients with SUI .However , further studies are necessary to confirm its diagnostic efficacy on pelvic floor muscle function in patients with other diseases .