目的:探讨血清总25-羟维生素D、血清雌二醇、膀胱尿道后角诊断女性压力性尿失禁(stress urina-ry incontinence,SUI)的临床价值.方法:选择2024年6月—9月于中部战区总医院泌尿外科就诊的30例女性SUI患者作为病例组,同期无SUI的健康体检女性30例作为对照组.比较分析2组受试者的血清总25-羟维生素D、血清雌二醇水平和经会阴二维超声中膀胱尿道后角的特点.采用受试者工作特征(receiver operating char-acteristic,ROC)曲线分析上述各项指标单独和联合检测的诊断效能.结果:病例组平均年龄(56.97±7.60)岁,体重指数(body mass index,BMI)(26.04±3.35)kg/m2,产史(1.93±0.74)次;对照组平均年龄(53.50±6.95)岁,体重指数(24.53±3.53)kg/m2,产史(1.63±0.72)次,2组年龄、产史、BMI比较差异无统计学意义(P＞0.05).病例组血清总25-羟维生素D及血清雌二醇水平较对照组显著降低(P＜0.05).病例组在静息状态下及最大Valsalva动作时膀胱尿道后角较对照组明显增大,且2组患者在行Valsalva动作时,病例组的膀胱尿道后角旋转角较对照组显著增大(P＜0.05).经ROC曲线分析发现,血清总25-羟基维生素D、血清雌二醇联合膀胱尿道后角诊断女性SUI的效能明显优于各单项指标诊断.结论:血清总25-羟维生素D、血清雌二醇、膀胱尿道后角可在女性SUI诊断方面提供一定帮助,且三者联合应用更具有临床诊断价值.
Serum total 25-hydroxyvitamin D and estradiol in combination with the posterior vesicourethral angle in the diagnosis of women with stress urinary incontinence
Objective:To explore the clinical value of total serum 25-hydroxyvitamin D,estradiol,and the posterior angle of the bladder-urethra in diagnosing female patients with stress urinary incontinence(SUI).Meth-ods:A total of 30 female patients with SUI admitted to the Central Theater General Hospital from June to Sep-tember 2024 were selected as the case group,while 30 healthy women without SUI were included as the control group.The total serum 25-hydroxyvitamin D,estradiol levels,and the characteristics of the posterior angle of the bladder-urethra observed via transperineal 2D ultrasound were compared between the two groups.The diagnostic efficacy of each indicator individually and in combination was analyzed using receiver operating characteristic(ROC)curves.Results:The average age of the case group was(56.97±7.60)years old,with a body mass index(BMI)of(26.04±3.35)kg/m2 and a childbirth history of(1.93±0.74)times.The control group had an aver-age age of(53.50±6.95)years old,a BMI of(24.53±3.53)kg/m2,and a childbirth history of(1.63±0.72)times.No statistically significant differences were found between the two groups in terms of age,childbirth histo-ry,or BMI(P＞0.05).Total serum 25-hydroxyvitamin D and estradiol significantly decreased in the case group compared to the control group(P＜0.05).Compared to the control group,the posterior angle of the bladder-ure-thra notably increased in the case group at rest and during maximum Valsalva maneuver,and the posterior angle rotation of the bladder-urethra was significantly greater in the case group during Valsalva maneuver(P＜0.05).ROC curve analysis revealed that the combined assessment of total serum 25-hydroxyvitamin D,estradiol,and the posterior angle of the bladder-urethra had a significantly superior diagnostic efficacy for female patients with SUI compared to any individual indicator.Conclusion:Total serum 25-hydroxyvitamin D,estradiol and the posterior angle of the bladder-urethra may be effective in diagnosing female patients with SUI,and the combination of the three has more clinical diagnostic value.
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