神经生长因子在逼尿肌过度活动中的诊断价值：混合性尿失禁女性的研究。

Diagnostic value of nerve growth factor in detrusor overactivity: a study on women with mixed urinary incontinence.

机构信息

Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.

Urology Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Int Urol Nephrol. 2021 Aug;53(8):1557-1562. doi: 10.1007/s11255-021-02864-0. Epub 2021 Apr 17.

DOI:10.1007/s11255-021-02864-0

PMID:33866484

Abstract

OBJECTIVE

Urinary incontinence has a profound impact on women's quality of life. Studies have shown that changes in urinary protein levels could be a potential diagnostic biomarker in some urological diseases. The aim of present study is to determine the diagnostic value of nerve growth factor (NGF) in women with mixed urinary incontinence (MUI) as a diagnostic biomarkers of detrusor overactivity (DO).

METHODS

Seventy women aged between 20 and 75 years with MUI were enrolled in this prospective study. All participants underwent urodynamic study. Urine NGF levels were measured using an ELISA method. NGF level was compared between groups using Mann-Whitney U test. Receiver Operator Characteristic (ROC) analysis was employed to evaluate the diagnostic performance of urinary NGF.

RESULTS

The results showed that the median (min, max) of NGF in patients with DO was significantly higher in comparing to its level in women without DO [184.10 (31, 346.60) pg/ml vs. 151.80 (21, 210.70)], respectively (P = 0.035). Using receiver-operator characteristics analysis, the threshold urinary NGF value of 102.00 pg/ml provided a sensitivity of 88% and specificity of 40% in diagnosing DO, PPV of 39.1%, and NPV of 88.2%, positive likelihood ratio 2.18 and negative likelihood ratio of 0.45 (P = 0.02).

CONCLUSION

Based on high sensitivity and low specificity, we can conclude that NGF can be a good tool for ruling out the OAB when the test is negative. However, the future investigations are needed to expand the observed correlation in larger groups of women with DO.

摘要

目的

尿失禁对女性生活质量有深远影响。研究表明，尿液蛋白水平的变化可能是一些泌尿科疾病的潜在诊断生物标志物。本研究旨在确定神经生长因子（NGF）在混合性尿失禁（MUI）女性中的诊断价值，作为逼尿肌过度活动（DO）的诊断生物标志物。

方法

本前瞻性研究纳入了 70 名年龄在 20 至 75 岁之间的 MUI 女性患者。所有参与者均接受尿动力学研究。采用 ELISA 法检测尿液 NGF 水平。采用 Mann-Whitney U 检验比较组间 NGF 水平。采用受试者工作特征（ROC）分析评估尿 NGF 的诊断性能。

结果

结果显示，DO 患者的 NGF 中位数（最小，最大）明显高于无 DO 患者[184.10（31，346.60）pg/ml 比 151.80（21，210.70）pg/ml]（P=0.035）。采用 ROC 分析，尿 NGF 值为 102.00 pg/ml 时，诊断 DO 的敏感度为 88%，特异度为 40%，PPV 为 39.1%，NPV 为 88.2%，阳性似然比为 2.18，阴性似然比为 0.45（P=0.02）。