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重复膀胱内注射富血小板血浆治疗间质性膀胱炎/膀胱疼痛综合征是安全有效的。

Repeated intravesical injections of platelet-rich plasma are safe and effective in the treatment of interstitial cystitis/bladder pain syndrome.

作者信息

Yu Wan-Ru, Jiang Yuan-Hong, Jhang Jia-Fong, Kuo Hann-Chorng

机构信息

Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.

出版信息

Tzu Chi Med J. 2024 Oct 16;37(1):72-79. doi: 10.4103/tcmj.tcmj_166_24. eCollection 2025 Jan-Mar.

Abstract

OBJECTIVES

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a challenging chronic inflammatory condition affecting the urinary bladder, with limited treatment options. This study aims to assess the clinical efficacy of repeated intravesical platelet-rich plasma (PRP) injections for promoting urothelial regeneration and reducing inflammation in patients with IC/BPS and investigate its correlation with subjective and objective treatment-related outcomes.

MATERIALS AND METHODS

Four monthly intravesical PRP injections were given to 98 patients with non-Hunner-type IC/BPS. Treatment outcomes were assessed using a global response assessment (GRA) score 3 months posttreatment. In addition, clinical symptom scores, pain severity, voiding diary data, uroflowmetry parameters, and GRA scores were compared before and after treatment and between different treatment outcome groups (satisfactory: GRA≥2 unsatisfactory: GRA<2). Baseline urine biomarkers were analyzed to identify potential treatment outcome predictors.

RESULTS

After four PRP injections, 54 (55.1%) patients reported satisfactory outcomes. Lower urinary tract symptoms, bladder pain, urinary frequency, anxiety, and flow rate significantly improved from baseline ( < 0.05) in all patients, regardless of the treatment outcome. All patients experienced improved treatment outcomes and increased maximum bladder capacity with successive PRP treatments, and no major complications were reported. Urine biomarkers indicated elevated inflammation and oxidative stress biomarkers in patients with IC/BPS compared to controls.

CONCLUSION

Repeated PRP injections are safe and effective for reducing symptoms and bladder pain and improving bladder capacity in a majority of IC/BPS patients, with better outcomes observed in patients with a mild form of bladder inflammation. These results support PRP as a promising novel bladder therapy for IC/BPS.

摘要

目的

间质性膀胱炎/膀胱疼痛综合征(IC/BPS)是一种具有挑战性的慢性炎症性疾病,影响膀胱,治疗选择有限。本研究旨在评估重复膀胱内注射富血小板血浆(PRP)促进IC/BPS患者尿路上皮再生和减轻炎症的临床疗效,并研究其与主观和客观治疗相关结果的相关性。

材料和方法

对98例非Hunner型IC/BPS患者每月进行4次膀胱内PRP注射。治疗后3个月使用整体反应评估(GRA)评分评估治疗结果。此外,比较治疗前后以及不同治疗结果组(满意:GRA≥2;不满意:GRA<2)之间的临床症状评分、疼痛严重程度、排尿日记数据、尿流率参数和GRA评分。分析基线尿液生物标志物以确定潜在的治疗结果预测指标。

结果

4次PRP注射后,54例(55.1%)患者报告结果满意。所有患者的下尿路症状、膀胱疼痛、尿频、焦虑和尿流率较基线均有显著改善(<0.05),无论治疗结果如何。所有患者在连续PRP治疗后治疗结果均有改善,最大膀胱容量增加,且未报告重大并发症。尿液生物标志物表明,与对照组相比,IC/BPS患者的炎症和氧化应激生物标志物升高。

结论

重复PRP注射对减轻大多数IC/BPS患者的症状和膀胱疼痛以及改善膀胱容量是安全有效的,在轻度膀胱炎症患者中观察到更好的结果。这些结果支持PRP作为一种有前景的IC/BPS新型膀胱治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ad8/11753520/6a35cc1b3985/TCMJ-37-72-g001.jpg

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