Bagińska-Chyży Joanna, Korzeniecka-Kozerska Agata
Department of Pediatrics and Nephrology, Medical University of Białystok, 17 Waszyngton Str., 15-274 Białystok, Poland.
Children (Basel). 2025 May 23;12(6):668. doi: 10.3390/children12060668.
Pediatric neurogenic bladder (NB), often resulting from myelomeningocele, impairs bladder function due to disrupted neural control and is worsened by urinary retention, recurrent urinary tract infections, the absence of voluntary voiding, and additional sequelae of myelomeningocele, such as motor impairments, delayed colonic transit, and nutritional deficiencies. Oxidative stress arises from an imbalance between oxidant production and the body's antioxidant defenses and is recognized as both a contributor to and a consequence of various pathological conditions. This study aims to assess the total antioxidant status (TAS) in NB patients, evaluate its impact on urinary antioxidants, and correlate the findings with the urodynamic parameters in NB patients compared to those in non-NB controls.
This study included 29 patients with NB, who were compared with 57 non-NB individuals. The comparative analyses encompassed serum and urinary total antioxidant status normalized to creatinine (uTAS/creatinine) and renal function markers (creatinine, urea, uric acid, and the glomerular filtration rate [GFR]), as well as urodynamic findings. TAS was determined using the colorimetric ABTS method.
The patients with NB demonstrated a significantly lower serum TAS and elevated urinary TAS and uTAS/creatinine ratios in comparison to these values in the control group ( < 0.001). Furthermore, a positive correlation was observed between uTAS/creatinine and detrusor pressure at the maximum cystometric capacity, while a negative correlation was found between uTAS/creatinine and bladder wall compliance (r = 0.5, r = -0.68 respectively).
The observed decrease in serum TAS and the increase in urinary TAS in NB may not only serve as evidence of an imbalance in antioxidant homeostasis but also suggest a potential contributory role to the deterioration of urodynamic function.
小儿神经源性膀胱（NB）通常由脊髓脊膜膨出引起，由于神经控制中断而损害膀胱功能，尿潴留、反复尿路感染、无法自主排尿以及脊髓脊膜膨出的其他后遗症（如运动障碍、结肠传输延迟和营养缺乏）会使病情恶化。氧化应激源于氧化剂产生与机体抗氧化防御之间的失衡，被认为是各种病理状况的促成因素和结果。本研究旨在评估NB患者的总抗氧化状态（TAS），评估其对尿抗氧化剂的影响，并将研究结果与NB患者和非NB对照组的尿动力学参数进行关联。
本研究纳入了29例NB患者，并与57例非NB个体进行比较。比较分析包括血清和尿中经肌酐标准化的总抗氧化状态（尿TAS/肌酐）以及肾功能指标（肌酐、尿素、尿酸和肾小球滤过率[GFR]），还有尿动力学检查结果。采用比色法ABTS测定TAS。
与对照组相比，NB患者的血清TAS显著降低，尿TAS和尿TAS/肌酐比值升高（<0.001）。此外，尿TAS/肌酐与最大膀胱测压容量时的逼尿肌压力呈正相关，而尿TAS/肌酐与膀胱壁顺应性呈负相关（分别为r = 0.5，r = -0.68）。
NB患者血清TAS降低和尿TAS升高，这不仅可能是抗氧化稳态失衡的证据，还可能提示其对尿动力学功能恶化有潜在的促成作用。
