摘要
目的探讨24h尿液钾离子浓度测定在治疗氯胺酮相关性膀胱炎过程中的应用方法和价值。方法氯胺酮相关性膀胱炎患者43例。男29例，女14例，年龄17～29岁，平均22岁。患者按入院治疗期间是否留置尿管分为A组（非留置组，32例）和B组（留置组，人院后即留置尿管，11例），两组均以抗炎、抗氧化、改善微循环、解痉镇痛及修复膀胱黏膜屏障为基础治疗方案。对照组为健康志愿者30名。各组均于治疗前后检测24h尿钾、尿钠和尿肌酐浓度。24h尿钾、尿钠浓度均以24h尿肌酐浓度作为内参，标准化后进行比较。A、B组于治疗前后行盆腔疼痛与尿急／尿频（PUF）评分。分析治疗前后组间、组内尿钾浓度的变化并分析与PUF评分的关系。结果各组治疗前后24h尿肌酐、尿钠浓度差异无统计学意义（P〉0．05）。尿钾浓度：①治疗前：A、B组及对照组分别为（1．80±0．67）、（6．22±0．92）、（6．47±0．97）mmolK／mmolCr，A组与B组、对照组比较差异均有统计学意义（P=0．0001）。②治疗后：3组分别为（6．23±1．42）、（6．02±0．98）、（6．47±0．97）mmolK／mmolCr，A组与B组、对照组比较差异均无统计学意义（P〉0．05）。PUF评分：①治疗前A组23．19±3．64，B组21．954-3．86，差异无统计学意义（t：1．302，P=0．200）；A组PUF评分与尿钾浓度呈负相关（r=-0．637，P=0．0001），B组与PUF评分无显著相关性（r=0．581，P=0．188）；②治疗后A组18．31±2．19，B组17．18±2．68，差异无统计学意义（t=-0．331，P=0．742）；A、B组PUF评分与尿钾浓度均呈负相关（A组：r=-0．427，P=0．015；B组：r=-0．779，P=0．005）。43例患者治疗前PUF评分22．77±3．63，治疗后18．12±2．83，治疗前后比较差异有统计学意义（t=6．347，P=0．0001）。结论尿钾浓度测定能较好评估氯胺酮相关性膀胱炎患者的病情及判断治疗效果。
Objective To investigate the relationship of 24 h urinary potassium （K） measurement and the symptoms change in kctamine-associated cystitis. Methods Forty-three ketamine-associated cys- titis patients （29 male cases, 14 female cases） were analyzed. The average age was 22 （17 -29） years. Thirty-two patients without indwelling urinary catheter were categorized as group A, while the other 11 pa- tients with indwelling urinary catheter were in group B. The therapy regimes consisted of anti-inflammatory, antioxidant, relieving spasm and pain, improving the microcirculation and repairing the bladder epithelium barrier. Thirty healthy adults were selected as the controls. Urinary K, sodium （Na） and creatinine （Cr） were determined in 24 h urine samples from all patients and controls before and after treatments. 24 h urina- ry Cr was used as the internal standard. 24 h urinary K and Na concentrations of the patients were calculated as relative to the Cr concentrations. The pelvic pain and urgency/frequency symptom （PUF） was used for evaluation before and after the treatments. The differences of urinary K were compared within each group and between groups before and after treatments. In addition, relationship of urinary K and PUF were assessed. Results Urinary Cr concentrations in all groups were not significantly different （P 〉 0.05）. Patients in group A had lower average K-to-Cr ratios than those patients in group B and controls （A 1.80± 0.67 vs. B 6.22±0.92 mmol K/mmol Cr, P =0. 0001 ; A 1.80±0.67 vs. controls 6.47±0.97 mmol K/mmol Cr, P = 0. 0001 ） before treatments. But the ratios of K-to-Cr in group A were not significantly different with group B and controls after treatments （A6.23 ±1.42 vs. B6.02±0.98 mmolK/mmolCr, A6.23 ±1.42 vs. controls 6.47 ±0.97 mmol K/mmol Cr, F = 0. 698, P = 0. 472）. PUF in both groups was not signifi- cantly different before treatments. For group A, PUF was negatively correlated with urinary K before and af- ter treatments （before： r= -0,637, P=0.0001; after： r= -0.427, P=0.015）. For group B, PUFhad no correlation with urinary K before treatment （ r = 0. 581, P = 0. 188） , while there was a negative correla- tion between them after treatments （r = - 0. 779, P = 0. 005 ）. PUF scores in all patients （ group A ＋ B ） were significantly decreased after treatments when compared to those before treatments （ 18.12 ± 2.83 vs. 22.77± 3.63, P = O. 0001 ）. Conclusion Urinary potassium measurement may have a role in evaluating the disease status and efficacy of treatments of patients suffered from ketamine-associated cystitis.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第11期863-867,共5页
Chinese Journal of Urology
基金
国家自然科学基金（81100540）
广东省自然科学基金（10451051501005788）
广东高校优秀青年创新人才培养计划（LYM10047）
关键词
氯胺酮
膀胱炎
钾
下尿路症状
Ketamine
Cystitis
Potassium
Lower urinary tract symptom
