女性膀胱过度活动症患者的尿液病毒组学和临床特征  

Urine virology and clinical characteristics of female patients with overactive bladder

作　　者：孙旗 李乐谦 周浩[2] 吴莹 吴炳义[4] 赵洁[5] 吴芃[1] Sun Qi;Li Leqian;Zhou Hao;Wu Ying;Wu Bingyi;Zhao Jie;Wu Peng(Department of Urology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Hospital Infection Management,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Biostatistics,School of Public Health,Southern Medical University,Guangzhou 510515,China;Medical Research Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Pharmacy,School of Pharmaceutical Sciences,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院泌尿外科,广州510515 [2]南方医科大学南方医院感染管理科,广州510515 [3]南方医科大学公共卫生学院生物统计学教研室,广州州510515 [4]南方医科大学南方医院临床医学实验研究中心,广州510515 [5]南方医科大学药学院药剂学教研室,广州510515

出　　处：《中华泌尿外科杂志》2023年第4期287-291,共5页Chinese Journal of Urology

基　　金：国家自然科学基金(82173304)。

摘　　要：目的探讨女性膀胱过度活动症(OAB)患者的尿液病毒组学和临床特征。方法采用横断面研究方法选取2021年1-8月于南方医科大学南方医院确诊OAB的女性患者(OAB组)和同期健康女性志愿者(对照组)。纳入标准:①>18岁女性;②符合国际尿控学会OAB诊断标准;③膀胱过度活动症症状评分(OABSS)总分≥3分, 尿急得分≥2分;④愿意参加并已签署知情同意书。排除标准:①尿常规或尿细菌培养阳性;②留置尿管状态;③近30 d有抗生素使用史;④其他明确病因引起的尿频、夜尿、尿急和尿失禁症状;⑤盆腔器官脱垂和妊娠;⑥有免疫抑制剂药物使用史和免疫疾病相关病史。收集两组的人口学特征资料, 进行OABSS和8项膀胱过度活动问卷(OAB-V8)评分。通过清洁导尿收集两组的尿液样本并提取DNA, 采用宏基因组二代测序(mNGS)评估两组的病毒感染情况。分析OAB与JC病毒感染的相关性, 构建预测病毒感染风险的列线图。结果本研究OAB组纳入55例, 对照组纳入18例。OAB组和对照组的泌尿道感染史例数(33例与3例, P=0.002)、盆腔手术史例数(24例与0例, P<0.01)和憋尿习惯例数(20例与1例, P=0.015)差异均有统计学意义。OAB组和对照组OABSS总分, 以及尿频、夜尿、尿急、尿失禁问题得分分别为5.0(4.0, 7.0)分和1.0(0, 1.0)分、1.0(1.0, 2.0)分和1.0(0, 1.0)分、1.0(1.0, 2.0)分和0、2.0(2.0, 4.0)分和0分、0分和0分;OAB-V8量表得分分别为17.0(10.0, 23.0)分和1.0(0, 1.0)分, 差异均有统计学意义(P<0.05)。mNGS结果显示, OAB组尿液样本中病毒检出例数多于对照组(26例和6例, P=0.41)。OAB组中JC病毒主要为7B亚型(8例), 对照组中JC病毒主要为7A亚型(2例)。相关性分析结果显示, OAB患者病毒感染与OABSS评分(r=0.58)、年龄和绝经史(r=0.68)、高血压病和年龄(r=0.53)均有高度相关性。OAB患者病毒感染的危险因素包括年龄(OR=1.99, 95%CI 0.02~2.61)、憋尿习惯(OR=2.16, Objective To investigate the urinary virology and clinical characteristics of female overactive bladder(OAB)patients.Methods Catheterized urine samples were collected from 55 women with OAB and 18 control individuals between January 2021 and August 2021.Inclusion criteria were:female with age>18,diagnosed as OAB,OABSS total score≥3 and item Urgency score≥2,informed consent signed.Exclusion criteria were:Urine culture positive,urinary catheter indwelling status,antibiotic usage in recent 30 days,other disease leading to OAB-like symptoms,pelvic organ prolapse and current pregnancy immunosuppressive therapy or status.Clinical characteristic and history were collected.OAB symptoms were assessed via both OABSS(overactive bladder symptom score)and OAB-V8(8-item overactive bladder questionnaire).The urine specimens were analyzed using mNGS for identifying viral infections.The correlation between the disease and JC virus infection was analyzed by t test,chi-square test,binary logistic regression analysis and Spearman correlation matrix,and the Nomogram map for predicting the risk of viral infection was constructed.Results In total,55 women with OAB and 18 healthy controls were recruited in the study.There are significant difference in terms of UTI history,pelvic surgery history and the habit of holding urine[60.0%(n=33)to 16.7%(n=3),P=0.002;43.6%(n=24)to 0.0%(n=0),P<0.01;36.4%(n=20)to 5.6%(n=1),P=0.015].Based on mNCS results,0AB patients were identified with more positive viral infection[47.3%(n=26)to 33.3%(n=6)]and more JC virus infection.In the 0AB group,subtype 7B of JCV(n=8)was identified,while in the control group,subtype 7A(n=2)was identified.Pairwise Spearman correlation analysis indicated high correlations between viral infection and OABSS(r=0.58),age and pausimenia(r=0.68),hypertension and age(r=0.53),respectively.Estimates from binary logistic regression model indicated risk factors for virus infection in OAB patients including age(OR=1.99,95%CI 0.02-2.61),holding urine habit(OR=2.16,95%CI 0.18-3.85)and pe

关 键 词：膀胱 过度活动性 宏基因组测序 病毒组学 

分 类 号：R694.5[医药卫生—泌尿科学]