Clustering of patients with overactive bladder syndrome.
Clustering of patients with overactive bladder syndrome.
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DOI：
10.1186/s12894-021-00812-9
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发表时间：
2021-03-19
期刊：
影响因子：
2
通讯作者：
Lai HH
中科院分区：
文献类型：
--
作者：
Gross J;Vetter JM;Lai HH
膀胱过度活动症是一种异质性疾病，临床表型特征不明显。为了发现膀胱过度活动症（OAB）患者的潜在患者亚型，我们使用了他们的泌尿系统症状和其他非泌尿系统因素的共识聚类。包括在k均值共识聚类的临床变量包括OAB症状，尿失禁，焦虑，抑郁，心理压力，躯体症状负担，报告的儿童创伤暴露，膀胱疼痛。纳入了48名寻求症状治疗的OAB患者。k-means共识聚类确定了OAB患者的两个聚类：泌尿聚类和全身聚类。系统性集群，其中包括约一半的队列（48%），其特点是显着较高的心理社会负担的焦虑（HADS-A，9.5 vs. 3.7，p < 0.001），抑郁（HADS-D，6.9 vs. 3.6，p < 0.001），心理压力（PSS，21.4 vs. 12.9，p < 0.001），躯体症状负担（PSPS-Q，28.0 vs. 7.5，p < 0.001），并报告了儿童时期暴露于创伤应激（CTES，17.0 vs. 5.4，p < 0.001）。全身性集群还报告了更强烈的膀胱疼痛（3.3 vs. 0.8，p = 0.002），疼痛分布更广泛（34.8% vs. 4.0%，p = 0.009）。系统性群集患者的尿失禁（ICIQ-UI，14.0 vs. 10.7，p = 0.028）和生活质量（SF-36，43.7 vs. 74.6，p < 0.001）更差。两组患者的尿急症状无法区分（ICIQ-OAB、OAB-q、IUSS，0-10分）。这两个OAB群与IC/BPS患者不同（急迫性尿失禁更严重，疼痛更轻）。OAB人群是异质性的，并且基于膀胱的聚类已经确定了OAB患者的两个聚类（全身聚类与膀胱聚类）。了解OAB亚型的病理生理学可能有助于治疗。
Overactive bladder is a heterogenous condition with poorly characterized clinical phenotypes. To discover potential patient subtypes in patients with overactive bladder (OAB), we used consensus clustering of their urinary symptoms and other non-urologic factors. Clinical variables included in the k-means consensus clustering included OAB symptoms, urinary incontinence, anxiety, depression, psychological stress, somatic symptom burden, reported childhood traumatic exposure, and bladder pain. 48 OAB patients seeking care of their symptoms were included. k-means consensus clustering identified two clusters of OAB patients: a urinary cluster and a systemic cluster. The systemic cluster, which consisted of about half of the cohort (48%), was characterized by significantly higher psychosocial burden of anxiety (HADS-A, 9.5 vs. 3.7, p < 0.001), depression (HADS-D, 6.9 vs. 3.6, p < 0.001), psychological stress (PSS, 21.4 vs. 12.9, p < 0.001), somatic symptom burden (PSPS-Q, 28.0 vs. 7.5, p < 0.001), and reported exposure to traumatic stress as a child (CTES, 17.0 vs. 5.4, p < 0.001), compared to the urinary cluster. The systemic cluster also reported more intense bladder pain (3.3 vs. 0.8, p = 0.002), more widespread distribution of pain (34.8% vs. 4.0%, p = 0.009). The systemic cluster had worse urinary incontinence (ICIQ-UI, 14.0 vs. 10.7, p = 0.028) and quality of life (SF-36, 43.7 vs. 74.6, p < 0.001). The two clusters were indistinguishable by their urgency symptoms (ICIQ-OAB, OAB-q, IUSS, 0–10 ratings). The two OAB clusters were different from patients with IC/BPS (worse urgency incontinence and less pain). The OAB population is heterogeneous and symptom-based clustering has identified two clusters of OAB patients (a systemic cluster vs. a bladder cluster). Understanding the pathophysiology of OAB subtypes may facilitate treatments.
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影响因子：
2
作者：
Reynolds, William Stuart;Brown, Elizabeth Timbrook;Bruehl, Stephen
通讯作者：
Bruehl, Stephen
影响因子：
6.6
作者：
Lai, H. Henry;North, Carol S.;Hong, Barry A.
通讯作者：
Hong, Barry A.
影响因子：
3.5
作者：
Coyne, K;Revicki, D;Abrams, P
通讯作者：
Abrams, P
DOI：
10.1016/j.juro.2017.03.132
发表时间：
2017-09
期刊：
The Journal of urology
影响因子：
--
作者：
Lai HH;Jemielita T;Sutcliffe S;Bradley CS;Naliboff B;Williams DA;Gereau RW 4th;Kreder K;Clemens JQ;Rodriguez LV;Krieger JN;Farrar JT;Robinson N;Landis JR;MAPP Research Network
通讯作者：
MAPP Research Network
影响因子：
2.3
作者：
McLachlan, G J
通讯作者：
McLachlan, G J