COVID⁃19对前列腺增生患者逼尿肌收缩功能的影响
作者:
作者单位:

1.桂林医学院第二附属医院泌尿外科,广西 桂林 541001 ;2.邵阳市中心医院泌尿外科尿控学研究室,湖南 邵阳 422600 ;3.中山大学孙逸仙纪念医院泌尿外科,广东 广州 510120

作者简介:

通讯作者:

肖宁,E-mail:xy20001816@163.com(ORCID:0000-0002-4842-0456)

中图分类号:

基金项目:

(十四五)国家重点研发计划(2022YFC3602904);桂林市创新平台和人才计划项目(20210218-2);湖南省临床医疗技术创新引导项目(2021SK52002)


Effect of the COVID-19 on detrusor contractility in patients with benign prostatic hyperplasia
Author:
Affiliation:

1.Department of Urology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541001 ;2.Continence Research Clinic,Department of Urology,Shaoyang Central Hospital,Shaoyang 422600 ;3.Department of Urology,Sun Yat⁃sen Memorial Hospital of Sun Yat⁃sen University,Guangzhou 510120 ,China

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:采用超声影像尿动力学检查(sonography video urodynamics studies,SVUDS)分析新型冠状病毒肺炎(coronavi- rus disease-2019,COVID-19)对前列腺增生(benign prostatic hyperplasia,BPH)患者逼尿肌收缩功能的影响。方法:纳入桂林医学院第二附属医院及邵阳市中心医院2023年1—6月诊断为BPH伴或不伴COVID-19感染患者124例进行回顾性研究分析。根据病毒核酸检测阳性或阴性情况分为COVID-19(+)组51例和COVID-19(-)组73例。比较两组患者一般情况、炎症指标及 SVUDS参数差异,分析COVID-19(+)组患者炎症指标及无创性SVUDS参数与逼尿肌收缩功能的相关性。结果:COVID-19(+) 组患者C反应蛋白(C-reactive protein,CRP)、白介素(interleukin,IL)-6高于COVID-19(-)组患者(P < 0.05)。两组患者年龄、IL- 1β、前列腺特异性抗原(prostate specific antigen,PSA)、游离前列腺特异性抗原(free prostate-specific antigen,fPSA)、fPSA/PSA、前列腺体积(prostate volume,PV)、前列腺特异性抗原密度(prostate specific antigen density,PSAD)、前列腺突入膀胱距离(intra- vesical prostatic protrusion,IPP)、最大尿流率(peak flow rate,Qmax)、尿道阻力因子(urethral resistance factor,URA)、膀胱出口梗阻指数(bladder outlet obstruction index,BOOI)、基点(footpoint)、曲率(curvature)差异无统计学意义(P > 0.05)。相比COVID-19 (-)组,COVID-19(+)组最大逼尿肌压(maximum detrusor pressure,Pdet.max)、最大尿流率逼尿肌压(detrusor pressure at peak flow rate,Pdet.Qmax)、膀胱收缩指数(bladder contractility index,BCI)和最大瓦特因子(maximum Watts factor,WFmax)降低,膀胱壁厚度(bladder wall thickness,BWT)和残余尿量(post-void residual volume,PVR)增加(P 均<0.05)。COVID-19(+)组患者 BWT 与 WFmax呈负相关(r=-0.313,P=0.036),PVR与BCI(r=-0.471,P=0.001)和WFmaxr=-0.491,P=0.001)均呈负相关。结论:BPH 患者若合并COVID-19感染可能进一步加重逼尿肌活动低下,导致残余尿量增加甚至尿潴留,逼尿肌活动低下可能是BPH患者 “long-COVID”尿动力学表现之一。

    Abstract:

    Objective:The effect of coronavirus disease-2019(COVID-19)on detrusor contractility in patients with benign prostatic hyperplasia(BPH)was investigated using sonography video urodynamics studies(SVUDS). Methods:The clinical dataset,including general condition,inflammatory indexes,and SVUDS parameters of 124 BPH patients with or without COVID-19 infection admitted to the Second Affiliated Hospital of Guilin Medical University and Shaoyang Central Hospital between January and June 2023 were retrospectively reviewed. Those patients were divided into the COVID-19(+)(n=51)and COVID-19(-)(n=73)groups according to the results of virus nucleic acid detection,and the differences in general corditions,inflammatory indicators,and SVUDS parameters were compared between two groups. The correlations of inflammatory indexes and non-invasive SVUDS parameters with detrusor contractility in BPH patients of the COVID -19(+)group were analyzed. Results:The serum level of C-reactive protein(CRP)and interleukin(IL)-6 of BPH patients in the COVID-19(+)group were significantly higher than that of the COVID-19(-)group(P < 0.05),whereas no significant differences in age,IL-1β,prostate specific antigen(PSA),free prostate-specific antigen(fPSA),fPSA/ PSA,prostate volume(PV),prostate specific antigen density(PSAD),intravesical prostatic protrusion(IPP),peak flow rate(Qmax), urethral resistance factor(URA),bladder outlet obstruction index(BOOI),footpoint,and curvature were found between the two groups (P > 0.05). Significant thicker bladder wall thickness(BWT),larger post -void residual volume(PVR),and lower value of detrusor contractility indexes,including maximum detrusor pressure(Pdet.max),detrusor pressure at peak flow rate(Pdet.Qmax),bladder contractility index(BCI)and maximum Watts factor(WFmax),were observed in BPH patients of the COVID(+)group,compared with those of the COVID(-)group(P <0.05). The negative correlations between BWT and WFmaxr=-0.313,P=0.036),between PVR and BCI(r=-0.471,P=0.001),and between PVR and WFmaxr=-0.491,P=0.001)were found in BPH patients of the COVID-19(+)group. Conclusion:COVID-19 may aggravate detrusor underactivity in BPH patients,resulting to the increased PVR even urinary retention, which may be one urodynamics features of long-COVID in those BPH patients.

    参考文献
    相似文献
    引证文献
引用本文

肖宁,肖锦华,黄海,唐琦,陈丹,黄秋夏,赵划晟,王建峰. COVID⁃19对前列腺增生患者逼尿肌收缩功能的影响[J].南京医科大学学报(自然科学版),2025,(1):22-28

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2024-07-12
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2025-01-15
  • 出版日期:
关闭