Chen Wei-Hsin, Jiang Yuan-Hong, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.
Department of Urology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan.
Biomedicines. 2023 Jan 26;11(2):357. doi: 10.3390/biomedicines11020357.
Ninety-three women with urodynamic stress incontinence (USI) and a mean age of 60.8 ± 10.7 (36-83) years were retrospectively enrolled. According to their VUDS, 31 (33%) were grouped into USI and detrusor overactivity (DO), 28 (30.1%) were grouped into USI and hypersensitive bladder (HSB), and 34 (36.6%) were controls (USI and stable bladder). The USI and DO group had significantly increased 8-isoprostane (mean, 33.3 vs. 10.8 pg/mL) and 8-hydroxy-2-deoxyguanosine (8-OHdG; mean, 28.9 vs. 17.4 ng/mL) and decreased interleukin (IL)-2 (mean, 0.433 vs. 0.638 pg/mL), vascular endothelial growth factor (mean, 5.51 vs. 8.99 pg/mL), and nerve growth factor (mean, 0.175 vs. 0.235 pg/mL) levels compared to controls. Oxidative stress biomarkers were moderately diagnostic of DO from controls, especially 8-isoprostane (area under the curve (AUC) > 0.7). Voided volume was highly diagnostic of DO from either controls or non-DO patients (AUC 0.750 and 0.915, respectively). The proposed prediction model with voided volume, 8-OHdG, and 8-isoprostane (cutoff values 384 mL, 35 ng/mL, and 37 pg/mL, respectively) had an accuracy of 81.7% (sensitivity, 67.7%; specificity, 88.7%; positive predictive value, 75.0%; negative predictive value, 84.6%). Combined with voided volume, urinary oxidative stress biomarkers have the potential to be used to identify urodynamic DO in patients with USI.
对93例平均年龄为60.8±10.7（36 - 83）岁的压力性尿失禁（USI）女性患者进行回顾性研究。根据其排尿期膀胱尿道造影（VUDS），31例（33%）被归为USI合并逼尿肌过度活动（DO）组，28例（30.1%）被归为USI合并膀胱过敏（HSB）组，34例（36.6%）为对照组（USI合并稳定膀胱）。与对照组相比，USI合并DO组的8 - 异前列腺素（平均，33.3对10.8 pg/mL）和8 - 羟基 - 2 - 脱氧鸟苷（8 - OHdG；平均，28.9对17.4 ng/mL）显著升高，而白细胞介素（IL）-2（平均，0.433对0.638 pg/mL）、血管内皮生长因子（平均，5.51对8.99 pg/mL）和神经生长因子（平均，0.175对0.235 pg/mL）水平降低。氧化应激生物标志物对区分对照组和DO具有中等诊断价值，尤其是8 - 异前列腺素（曲线下面积（AUC）> 0.7）。排尿量对区分对照组和DO患者或非DO患者的DO具有较高诊断价值（AUC分别为0.750和0.915）。所提出的基于排尿量、8 - OHdG和8 - 异前列腺素（截断值分别为384 mL、35 ng/mL和37 pg/mL）的预测模型准确率为81.7%（敏感性，67.7%；特异性，88.7%；阳性预测值，75.0%；阴性预测值，84.6%）。结合排尿量，尿氧化应激生物标志物有可能用于识别USI患者的尿动力学DO。
