Matthiesen T B, Rittig S, Djurhuus J C
Institute of Experimental Clinical Research, Aarhus University Hospital-Skejby, DK-8200 Aarhus N, Denmark.
APMIS Suppl. 2003(109):59-65.
Previous studies in males with lower urinary tract symptoms (LUTS) have shown that nocturia in some patients is associated with nocturnal polyuria whereas other patients have preserved circadian urine output rhythm. This outpatient study based on 7-dayss frequency/volume (FV) charts showed that patients with nocturnal polyuria and age-matched controls without nocturia had a diurnal variation in functional bladder capacity (FBC) with higher night-time values. In contrast, patients without nocturnal polyuria no diurnal variation was observed in FBC with lower day and night-time values than both controls and nocturnal polyuric patients. Nocturia volumes correlated significantly to daytime FBC in both patient groups. Voided volumes obtained from daytime pressure/flow urodynamic investigations correlated significantly with night-time FBC obtained from the FV chart. In patients with LUTS nocturia was caused by nocturnal polyuria in 10 of 23 patients and by diminished night-time functional bladder capacity in the remaining 13 patients. In conclusion, nocturia in males with LUTS referred for BPH evaluation is caused by a mismatch between nocturnal urine production and night-time FBC analogous with the pathophysiology of nocturnal enuresis. The evaluation of circadian urine production and FBC seems mandatory in the assessment of patients with nocturia and LUTS.
先前针对下尿路症状（LUTS）男性患者的研究表明，部分患者的夜尿症与夜间多尿有关，而其他患者则保持昼夜尿量节律。这项基于7天频率/尿量（FV）图表的门诊研究显示，夜间多尿的患者以及年龄匹配的无夜尿症对照组患者的功能性膀胱容量（FBC）存在昼夜变化，夜间值更高。相比之下，无夜间多尿的患者未观察到FBC的昼夜变化，其白天和夜间值均低于对照组和夜间多尿患者。两组患者的夜尿量均与白天FBC显著相关。通过白天压力/流率尿动力学检查获得的排尿量与通过FV图表获得的夜间FBC显著相关。在LUTS患者中，23例患者中有10例的夜尿症是由夜间多尿引起的，其余13例患者的夜尿症是由夜间功能性膀胱容量减小引起的。总之，因良性前列腺增生（BPH）评估而转诊的LUTS男性患者的夜尿症是由夜间尿量产生与夜间FBC不匹配所致，这与夜间遗尿症的病理生理学类似。在评估夜尿症和LUTS患者时，评估昼夜尿量产生和FBC似乎是必要的。
