Erickson Deborah R, Kunselman Allen R, Bentley Christina M, Peters Kenneth M, Rovner Eric S, Demers Laurence M, Wheeler Marcia A, Keay Susan K
Department of Surgery, Division of Urology, University of Kentucky College of Medicine, Lexington, Kentucky 40536-0298, USA.
J Urol. 2007 Feb;177(2):556-60. doi: 10.1016/j.juro.2006.09.029.
We evaluated changes in urine markers and symptom scores after bladder distention in patients with interstitial cystitis.
Study subjects were 33 new patients who had undergone no prior interstitial cystitis treatment. Urine specimens were taken before and 1 month after bladder distention. University of Wisconsin symptom scores were done the same day as the urine specimen collection. Urine marker levels and symptom scores before and after distention were compared. Changes in markers were tested for associations with changes in symptom scores and other markers. Markers and specific symptoms before distention were tested for their association with post-distention symptom improvement.
After distention the median total University of Wisconsin score decreased significantly (28.5 before, 20 after, p <0.001). A total of 12 patients (36%) had at least 30% improvement in University of Wisconsin score, and 8 patients (24%) had at least 50% improvement. No pre-distention markers or symptoms predicted which patients would have a good response. There were 2 urine markers that improved significantly after distention: anti-proliferative factor activity (median -96% before, -17% after, p <0.001) and heparin-binding epidermal growth factor-like growth factor levels (median 0.34 ng/mg creatinine before, 4.1 after, p <0.001). None of the changes in urine markers associated with changes in symptom scores.
The median symptom score for newly diagnosed patients with interstitial cystitis decreased after distention, but only a minority of patients had at least 30% symptom improvement. Bladder distention altered urine anti-proliferative factor activity and heparin-binding epidermal growth factor-like growth factor levels toward normal, but the mechanism of symptom relief after distention is still unknown.
我们评估了间质性膀胱炎患者膀胱扩张后尿液标志物和症状评分的变化。
研究对象为33例未曾接受过间质性膀胱炎治疗的新患者。在膀胱扩张前及扩张后1个月采集尿液标本。威斯康星大学症状评分与尿液标本采集在同一天进行。比较扩张前后的尿液标志物水平和症状评分。测试标志物的变化与症状评分及其他标志物变化之间的关联。测试扩张前的标志物和特定症状与扩张后症状改善之间的关联。
扩张后威斯康星大学总评分中位数显著下降（之前为28.5，之后为20，p<0.001）。共有12例患者（36%）威斯康星大学评分至少改善了30%，8例患者（24%）至少改善了50%。扩张前的标志物或症状无法预测哪些患者会有良好反应。有2种尿液标志物在扩张后显著改善：抗增殖因子活性（中位数之前为-96%，之后为-17%，p<0.00）和肝素结合表皮生长因子样生长因子水平（中位数之前为0.34 ng/mg肌酐，之后为4.1，p<0.001）。尿液标志物的变化与症状评分的变化均无关联。
新诊断的间质性膀胱炎患者膀胱扩张后症状评分中位数下降，但只有少数患者症状改善至少30%。膀胱扩张使尿液抗增殖因子活性和肝素结合表皮生长因子样生长因子水平趋于正常，但扩张后症状缓解的机制仍不清楚。
