Insights into the development of a new index, vesical adaptation response to diuresis, for understanding lower urinary tract dysfunction
Insights into the development of a new index, vesical adaptation response to diuresis, for understanding lower urinary tract dysfunction
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深入了解新指标（膀胱对利尿的适应反应）的开发，以了解下尿路功能障碍
DOI：
10.1111/iju.14769
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发表时间：
2022
影响因子：
2.6
通讯作者：
Kojima Yoshiyuki
中科院分区：
文献类型：
--
作者：
Matsuoka Kanako;Akaihta Hidenori;Hata Junya;Imai Hitomi;Tanji Ryo;Honda‐Takinami Ruriko;Hoshi Seiji;Koguchi Tomoyuki;Sato Yuichi;Kataoka Masao;Ogawa Soichiro;Kojima Yoshiyuki
目的 阐明膀胱适应反应（不断改变排尿量以适应利尿的稳态系统）如何参与男性下尿路症状和膀胱储存功能。方法我们纳入了 65 岁以上患有下尿路症状的男性患者。膀胱对利尿的适应反应被定义为排尿率与 3 天感觉相关频率容量图上的排尿量之间的正相关。根据是否存在对利尿的膀胱适应反应将患者分为两组，并比较组间特征。结果最终对94名男性患者进行分析。 48 名患者 (51%) 发现膀胱对利尿有适应反应，46 名患者 (49%) 缺乏膀胱适应反应。对利尿没有膀胱适应反应的患者更常被诊断为膀胱过度活动症（P= 0.04）。调整混杂因素后，膀胱对利尿适应反应的缺失与膀胱过度活动症（调整后的比值比 3.76，95% 置信区间 1.34–10.55；P= 0.01）和良性前列腺肥大（调整后的比值比 1.04，95% 置信区间 1.01–1.07；P= 0.02）显着相关。膀胱对利尿的适应反应，其特征是利尿阶段排尿量减少，可以解释为膀胱储存功能障碍的一种形式。膀胱对利尿的适应反应的评估可能提供膀胱储存功能的新指标，并有助于更好地了解下尿路症状患者膀胱储存功能障碍的病理生理学。
ObjectivesTo clarify how vesical adaptation response, the homeostatic system that constantly changes voided volume to adapt to diuresis, is involved in male lower urinary tract symptoms and bladder storage function.MethodsWe included male patients older than 65 years with lower urinary tract symptoms. Vesical adaptation response to diuresis was defined as a positive correlation between urine output rate and voided volume on 3‐day sensory‐related frequency volume charts. Patients were divided into two groups according to the presence or absence of vesical adaptation response to diuresis, and characteristics were compared between groups.ResultsNinety‐four male patients were finally analyzed. Vesical adaptation response to diuresis was found in 48 patients (51%) and was lacking in 46 patients (49%). Patients without vesical adaptation response to diuresis were significantly more often diagnosed with overactive bladder (P= 0.04). After adjusting for confounders, absence of vesical adaptation response to diuresis was significantly associated with overactive bladder (adjusted odds ratio 3.76, 95% confidence interval 1.34–10.55;P= 0.01) and benign prostatic enlargement (adjusted odds ratio 1.04, 95% confidence interval 1.01–1.07;P= 0.02).ConclusionsThe absence of vesical adaptation response to diuresis, characterized by decreased voided volume during a diuretic phase, can be interpreted as a form of bladder storage dysfunction. Assessment of vesical adaptation response to diuresis may provide a new index of bladder storage function and contribute to a better understanding of the pathophysiology underlying bladder storage dysfunction in patients with lower urinary tract symptoms.
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影响因子：
3.7
作者：
Haga N;Aikawa K;Hoshi S;Yabe M;Akaihata H;Hata J;Sato Y;Ogawa S;Ishibashi K;Kojima Y
通讯作者：
Kojima Y
影响因子：
2
作者：
Kubota, Yasue;Hashitani, Hikaru;Kohri, Kenjiro
通讯作者：
Kohri, Kenjiro
下尿路功能障碍症状研究网络 (LURN) 队列的三天排尿日记的结果是否可行且可靠？
影响因子：
2
作者：
Anne P Cameron;Jonathan B. Wiseman;Abigail R. Smith;R. Merion;Brenda W. Gillespie;Catherine S. Bradley;Cindy L. Amundsen;Claire C. Yang;H. Lai;J. Delancey;M. Helmuth;Megan S. Bradley;N. Agochukwu*;V. Andreev;Z. Kirkali;J. Q. Clemens
通讯作者：
J. Q. Clemens
影响因子：
6.6
作者：
Redmond, Elaine J.;O'Kelly, Therese;Flood, Hugh D.
通讯作者：
Flood, Hugh D.
影响因子：
2.1
作者：
Homma, Yukio;Yoshida, Masaki;Nishizawa, Osamu
通讯作者：
Nishizawa, Osamu