PDF(Pubmed)
Abstract：
Kidney stones and infections significantly affect patients\' health-related quality of life (HRQOL); however, the relationship between urinary tract infections (UTIs) and HRQOL in patients with kidney stones remains unclear. This study aimed to investigate the relationship using the validated Chinese version of the Wisconsin Stone Quality of Life questionnaire (C-WISQOL). We prospectively recruited 307 patients with kidney stones to complete the C-WISQOL before and after stone removal. The participants were diagnosed with UTI based on the presence of pyuria or bacteriuria with or without clinical symptoms. The psychometric properties of the C-WISQOL were statistically analyzed. Multivariate linear regression was used to predict the risk factors for impaired HRQOL in patients with stones and UTIs. The questionnaire is a reliable and robust tool for evaluating HRQOL in Chinese-speaking patients with urolithiasis. The UTI and kidney stone co-occurrence was significantly associated with female sex, diabetes mellitus, more previous stone events, higher antibiotic usage, positive stone- or UTI-related symptoms, and postoperative residual stones. The preoperative C-WISQOL scores and improvement in the HRQOL after stone removal in patients clinically diagnosed with UTI were significantly inferior to those in patients without UTI. The regression analyses showed that worse HRQOL was predicted by more previous stone events and positive stone- or UTI-related symptoms. In contrast, the presence of diabetes mellitus and postoperative residual stone fragments predicted a lower improvement in the HRQOL. These findings underscore UTI\'s harmful impact on perioperative HRQOL in patients with kidney stones and could help strategies benefit those patients.
摘要：
肾结石和感染显著影响患者的健康相关生活质量(HRQOL);然而,肾结石患者尿路感染(UTI)与HRQOL之间的关系尚不清楚.本研究旨在使用经过验证的中文版本的威斯康星州石头生活质量问卷（C-WISQOL）来调查这种关系。我们前瞻性招募了307名肾结石患者，以在结石清除前后完成C-WISQOL。参与者被诊断为UTI基于存在脓尿或有或没有临床症状的菌尿。对C-WISQOL的心理测量特性进行了统计分析。采用多元线性回归预测结石合并尿路感染患者HRQOL受损的危险因素。该问卷是评估华语尿石症患者HRQOL的可靠而有力的工具。UTI和肾结石的同时发生与女性性别显着相关，糖尿病,更多以前的石头事件，更高的抗生素使用率，与结石或UTI相关的积极症状，术后残余结石。临床诊断为UTI的患者的术前C-WISQOL评分和结石清除后HRQOL的改善明显不如无UTI的患者。回归分析显示，更多先前的结石事件和与结石或UTI相关的阳性症状可预测HRQOL恶化。相比之下,糖尿病和术后残余结石的存在预示着HRQOL的改善较低.这些发现强调了UTI对肾结石患者围手术期HRQOL的有害影响，并可能有助于这些患者受益的策略。
