COVID-19感染对前列腺增生患者逼尿肌收缩功能的影响
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桂林医学院第二附属医院

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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);(十四五)国家重点研发计划(2022YFC3602904);


Effect of COVID-19 infections on detrusor contractility in patients with benign prostatic hyperplasia
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Guilin Innovation platform and Talent Plan Project (20210218-2); Planned projects of Guiding technological innovation of Hunan Province (2021SK52002); National Key Research and Development Program of China(2022YFC3602904)。

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    摘要:

    目的:采用超声影像尿动力学检查(SVUDS)分析COVID-19感染对前列腺增生(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月-2023年6月间诊断为BPH伴或不伴COVID-19感染的患者124例进行回顾性研究分析。根据COVID-19病毒核酸检测阳性或阴性情况分为COVID-19(+)组和COVID-19(-)组。比较两组患者一般情况、炎症指标及SVUDS参数差异,以及分析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CRP、IL-6高于COVID-19(-)组患者(P <0.05)。两组患者的年龄、IL-1β、PSA、fPSA、fPSA/PSA、前列腺体积(PV)、PSAD、前列腺突入膀胱距离(IPP)、最大尿流率(Qmax)、URA、膀胱出口梗阻指数(BOOI)、足点(footpoint)、曲率(curvature)差异无统计学意义(P > 0.05)。相较COVID-19(-)组,COVID-19(+)组最大逼尿肌压(Pdet.max)最大尿流率逼尿肌压(Pdet.Qmax)、逼尿肌收缩指数(BCI)和最大瓦特因子(WFmax)降低(P < 0.05),逼尿肌厚度(BWT)和膀胱残余尿量(PVR)增加(P < 0.05)。COVID-19(+)组患者的BWT与WFmax呈负相关(R=-0.313,P=0.036),PVR与BCI(R=-0.471,P=0.001)和WFmax(R=-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(DU),导致残余尿量增加甚至尿潴留,DU可能是老年BPH/BOO患者“long-COVID”尿动力学表现之一。

    Abstract:

    Objective: The effect of COVID-19 infections on detrusor contractility in patients with benign prostatic hyperplasia (BPH) was investigated using ultrasonography video urodynamics studies (SVUDS). Methods:The clinical dataset, including general condition, inflammatory indexs, 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 Jan 2023 and June 2023 were retrospectively reviewed. Those patients were divided into COVID-19(+) and COVID-19(-) group according to the results of COVID-19 nucleic acid detection and clinical data over mentioned were compared between two groups. The correlation between inflammatory indexs and non-invasive SVUDS parameters and detrusor contractility in BPH patients of COVID-19(+) group were analyzed. Results:The serum level of CRP and IL-6 of BPH patients in COVID-19 (+) group were significantly higher than that of COVID-19 (-) group, whereas no significant differences in age, IL-1β, PSA, fPSA, fPSA/PSA, PV, PSAD, IPP, Qmax, URA, BOOI, footpoint, and curvature were found between two groups. Significant thicker BWT, larger PVR,and lower value of detrusor contractility indexs, including Pdet.max, Pdet.Qmax, BCI, and WF?max, were discerned in BPH patients of COVID (+) group compared to that of COVID (-) group. The negative correlation between BWT and WF?max, PVR and BCI, and PVR and WF?max was found in BPH patients of COVID-19 (+) group. Conclusions:COVID-19 might aggravate detrusor underactivity (DU) in BPH patients, resulting to increased PVR even urinary retention, which may be one urodynamic features of long-COVID in those patients.

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  • 收稿日期:2024-07-12
  • 最后修改日期:2024-10-07
  • 录用日期:2024-12-16
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