Detrusor botulinum toxin A injection significantly decreased urinary tract infection in patients with traumatic spinal cord injury
Detrusor botulinum toxin A injection significantly decreased urinary tract infection in patients with traumatic spinal cord injury
复制标题
逼尿肌A型肉毒毒素注射可显着减少创伤性脊髓损伤患者的尿路感染
DOI：
10.1038/sc.2012.180
复制
发表时间：
2013-06-01
期刊：
影响因子：
2.2
通讯作者：
Sui, Y.
中科院分区：
文献类型：
--
作者：
Jia, C.;Liao, L-M;Sui, Y.
研究设计：本研究设计为单臂临床试验。目的：探讨逼尿肌肉毒毒素A （BoNTA）注射液对脊髓损伤（SCI）患者尿路感染（UTI）的影响。环境：本研究在中国国家康复研究中心进行。方法：2010年9月至2012年5月，41例外伤性脊髓损伤致神经源性逼尿肌过度活动（NDO）的男性住院患者，平均年龄36.0±8.8岁，自纳入脊髓损伤以来病程21.5±17.3个月，接受300 U BoNTA逼尿肌注射。在注射前和注射后3个月，每位患者记录膀胱日记，进行尿动力学视频检查和尿液培养。记录注射前后6个月发生的所有尿路感染。结果：注射前6个月平均尿路感染数为1.39±1.36。注射后的平均值显著降低至0.78±0.96 （P= 0.023）。逼尿肌过度活动组（n= 24）与逼尿肌正常活动组（n= 17）相比，注射后充填时逼尿肌平均最大压力显著降低（35.4±12.2 vs 20.9±7.9 cmh2o， P= 0.000），同时前者的UTI显著降低（1.29±1.21 vs 0.41±0.62 cmh2o， P= 0.015），后者无显著降低（1.46±1.47 vs 1.04±1.08，P= 0.319）。结论：逼尿肌BoNTA注射可显著降低脊髓损伤合并NDO患者的UTI。这种效果似乎与逼尿肌压力的降低有关。
Study design:The study was designed as a single-arm clinical trial.Objectives:To investigate the effect of detrusor botulinum toxin A (BoNTA) injection on urinary tract infection (UTI) in patients with spinal cord injury (SCI).Setting:The study was performed in a national rehabilitation research center of China.Methods:Between September 2010 and May 2012, 41 male inpatients with neurogenic detrusor overactivity (NDO) caused by traumatic SCI, mean age 36.0±8.8 years, duration of SCI since inclusion 21.5±17.3 months, received an injection of 300 U BoNTA into detrusor. Before and 3 months after injection, each patient kept a bladder diary, underwent video-urodynamic investigation and urine culture. All UTIs occurring in the 6 months before and the 6 months after injection were recorded.Results:Before injection, the mean number of UTI over 6 months was 1.39±1.36. After injection, the mean significantly decreased to 0.78±0.96 (P= 0.023). The mean maximum detrusor pressure during filling decreased significantly in the patients of detrusor overactivity (n= 24) compared with patients of normo-active detrusor (n= 17) after injection (35.4±12.2 vs 20.9±7.9 cmH 2 O, P= 0.000), meantime, the decrease of UTI was significant in the former (1.29±1.21 vs 0.41±0.62 cmH 2 O, P= 0.015) while no significant in the latter (1.46±1.47 vs 1.04±1.08, P= 0.319).Conclusion:Detrusor BoNTA injection significantly decreased UTI in SCI patients with NDO. This effect seems to be related to the decrease of detrusor pressure.