Asplund Ragnar
Department of Family Medicine, Karolinska Institute, Stockholm, Sweden.
BJU Int. 2005 Sep;96 Suppl 1:15-21. doi: 10.1111/j.1464-410X.2005.05653.x.
Nocturia is a common condition in the elderly that profoundly influences general health and quality of life. It appears to predict a higher risk of death. One consequence of nocturia is sleep deterioration, with increased daytime sleepiness and loss of energy and activity. Accidents, e.g. falls, are increased both at night and during the day in elderly persons with nocturia. Nocturia is caused by nocturnal polyuria, reduced voided volumes, or a combination of the two. Nocturnal polyuria can be caused by numerous diseases, e.g. diabetes insipidus, diabetes mellitus, congestive heart failure, and sleep apnoea. A disorder of the vasopressin system, with very low or undetectable vasopressin levels at night, is manifested as an increased nocturnal urine output, which in the most extreme cases reaches 85% of the 24-h diuresis: the prevalence of low or undetectable vasopressin levels at night has been estimated to be 3-4% in those aged >or= 65 years. Treatment of nocturia may include avoiding excessive fluid intake and use of diuretic medication in the afternoon rather than the morning, oral desmopressin at bedtime in cases of nocturnal polyuria, and antimuscarinic agents in the case of overactive bladder or impaired storage capacity of the bladder.
夜尿症是老年人的常见病症，会对总体健康和生活质量产生深远影响。它似乎预示着更高的死亡风险。夜尿症的一个后果是睡眠质量下降，白天嗜睡增加，精力和活动减少。在患有夜尿症的老年人中，夜间和白天的事故（如跌倒）都会增加。夜尿症是由夜间多尿、排尿量减少或两者共同作用引起的。夜间多尿可能由多种疾病引起，如尿崩症、糖尿病、充血性心力衰竭和睡眠呼吸暂停。抗利尿激素系统紊乱，夜间抗利尿激素水平极低或检测不到，表现为夜间尿量增加，在最极端的情况下，夜间尿量可达24小时尿量的85%：据估计，年龄≥65岁人群中夜间抗利尿激素水平低或检测不到的患病率为3%-4%。夜尿症的治疗方法可能包括避免过量饮水，下午而非早晨使用利尿剂，夜间多尿时睡前口服去氨加压素，膀胱过度活动症或膀胱储尿功能受损时使用抗胆碱能药物。
