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氯胺酮相关性下尿路症状伴发尿路感染患者的流行病学特征及危险因素:一项横断面研究

Epidemiologic characteristics and risk factors in patients with ketamine-associated lower urinary tract symptoms accompanied by urinary tract infection: A cross-sectional study.

作者信息

Liu Weihua, Wu Weiwei, Wei Yongbao, Wu Jinfeng, Li Tao, Zhu Qingguo, Ye Liefu, Hong Fuyuan, Gao Yunliang, Yang Jinrui

机构信息

Shengli Clinical Medical College of Fujian Medical University.

Department of Nephrology, Fujian Provincial Hospital.

出版信息

Medicine (Baltimore). 2019 Jun;98(23):e15943. doi: 10.1097/MD.0000000000015943.

Abstract

Young adults with longstanding ketamine abuse present with lower urinary tract symptoms (LUTSs), which may be accompanied by urinary tract infection (UTI). However, the morbidity and risk factors for ketamine-associated LUTS accompanied by UTI (KALAUTI) are still unknown. To ascertain these, we surveyed patients with a history of ketamine abuse and LUTS at the time of their initial presentation.One hundred untreated patients with ketamine-associated LUTS were initially surveyed at 3 medical institutions. The patients' basic demographic and clinical information, KALAUTI status, and possible risk factors were obtained via a questionnaire and analyzed.Eighty-one patients were finally enrolled. Eight patients (9.88%) had a definitive diagnosis of KALAUTI and 16 (19.75%) had suspected KALAUTI. The diagnosis of KALAUTI was ruled out in the remaining 57 patients (70.37%). Patients with upper urinary tract involvement, longer duration of drug use, or more severe LUTS (P < .05), were more prone to KALAUTI. Frequent urine culture and a higher voiding symptom score (VSS) were risk factors for KALAUTI (P < .05), increasing the risk of KALAUTI by 44.241- and 1.923-fold, respectively.The study indicates that frequent urine culture and severe VSS are risk factors for KALAUTI. The possibility of UTI should be considered in ketamine abusers with LUTS in the clinical setting.

摘要

长期滥用氯胺酮的年轻成年人会出现下尿路症状(LUTSs),可能伴有尿路感染(UTI)。然而,氯胺酮相关下尿路症状伴发尿路感染(KALAUTI)的发病率及危险因素仍不清楚。为了确定这些情况,我们在初次就诊时对有氯胺酮滥用史且有下尿路症状的患者进行了调查。

最初在3家医疗机构对100例未经治疗的氯胺酮相关下尿路症状患者进行了调查。通过问卷调查获取患者的基本人口统计学和临床信息、KALAUTI状况及可能的危险因素,并进行分析。

最终纳入81例患者。8例(9.88%)确诊为KALAUTI,16例(19.75%)疑似KALAUTI。其余57例患者(70.37%)排除KALAUTI诊断。上尿路受累、用药时间较长或下尿路症状更严重的患者(P < 0.05)更容易发生KALAUTI。频繁进行尿培养和较高的排尿症状评分(VSS)是KALAUTI的危险因素(P < 0.05),分别使KALAUTI的风险增加44.241倍和1.923倍。

该研究表明,频繁进行尿培养和严重的VSS是KALAUTI的危险因素。在临床环境中,对于有下尿路症状的氯胺酮滥用者应考虑尿路感染的可能性。

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本文引用的文献

1
Delayed Urinary Symptoms Induced by Ketamine.氯胺酮致延迟性排尿症状
J Psychoactive Drugs. 2018 Apr-Jun;50(2):129-132. doi: 10.1080/02791072.2017.1371364. Epub 2017 Sep 21.
2
Risk Factors of Lower Urinary Tract Syndrome among Ketamine Users.氯胺酮使用者下尿路综合征的危险因素
Low Urin Tract Symptoms. 2018 Sep;10(3):281-286. doi: 10.1111/luts.12178. Epub 2017 Jul 13.
6
Ketamine-induced upper urinary tract lesions deserve more attention.氯胺酮引起的上尿路病变值得更多关注。
Neurourol Urodyn. 2017 Mar;36(3):824-825. doi: 10.1002/nau.23033. Epub 2016 May 13.
7
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Scand J Urol. 2014 Oct;48(5):482-8. doi: 10.3109/21681805.2014.909530. Epub 2014 Apr 30.
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Hong Kong Med J. 2013 Aug;19(4):341-8. doi: 10.12809/hkmj134013. Epub 2013 Jul 8.
10
Gourd-shaped bladder associated with ketamine abuse.与氯胺酮滥用相关的葫芦形膀胱。
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